Wilbring Manuel, Tugtekin Sems Malte, Matschke Klaus, Kappert Utz
Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany.
Thorac Cardiovasc Surg. 2014 Feb;62(1):80-2. doi: 10.1055/s-0032-1330225. Epub 2013 Jan 23.
We report the clinical course of a patient with a history of transapical aortic "valve-in-valve" transcatheter aortic valve implantation (TAVI), actually suffering from prosthetic valve endocarditis. The patient now underwent cardiac surgery as a salvage procedure. The procedure itself was uneventful, but the patient died several days postoperative due to persisting sepsis. The present case raises the question, how to deal with high-risk patients, once considered unsuitable for cardiac surgery in presence of prosthetic valve infection? Up to now, there exists only insufficient knowledge about incidence, clinical course, and effectiveness of treatment strategies for prosthetic valve endocarditis after TAVI. A review of the available literature is given.
我们报告了一名有经心尖主动脉“瓣中瓣”经导管主动脉瓣植入术（TAVI）病史的患者的临床病程，该患者实际患有人工瓣膜心内膜炎。患者目前接受了心脏手术作为挽救措施。手术本身过程顺利，但患者术后数天因持续败血症死亡。本病例提出了一个问题，即对于一旦被认为在人工瓣膜感染时不适合心脏手术的高危患者应如何处理？到目前为止，关于TAVI术后人工瓣膜心内膜炎的发病率、临床病程及治疗策略的有效性，我们所知甚少。本文对现有文献进行了综述。
