Farag Mina, Weymann Alexander, Schmack Bastian, Rauch Helmut, Karck Matthias, Szabó Gábor
Department of Cardiac Surgery, Heart Center - University of Heidelberg, Heidelberg, Germany.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:730-3. doi: 10.5761/atcs.cr.13.02275. Epub 2013 Jun 26.
Infection is the most common cause of death in hemodialysis patients after cardiovascular complications. The long-term use of venous catheters for dialysis elevates the risk. Valvular calcification is of special concern in developing infective endocarditis and is often found in chronic dialysis patients. The right-sided endocarditis is rarely reported in the literature and may be overseen until the development of further complications. In our case tricuspid valve endocarditis, with severe insufficiency and stenosis due to a calcified laminar plate was found in a 57-year-old female patient undergoing dialysis due to end-stage renal disease. The calcification aroused from the tip of the dual lumen tunneled venous catheter used for routine dialysis. We replaced the tricuspid valve with mechanical valve prosthesis and reconstructed the right atrium.
感染是血液透析患者继心血管并发症之后最常见的死亡原因。长期使用静脉导管进行透析会增加风险。瓣膜钙化在感染性心内膜炎的发生中特别值得关注，并且在慢性透析患者中经常发现。右侧心内膜炎在文献中报道较少，可能直到出现进一步并发症才会被发现。在我们的病例中，一名57岁因终末期肾病接受透析的女性患者被发现患有三尖瓣心内膜炎，由于钙化的板层导致严重的关闭不全和狭窄。钙化源自用于常规透析的双腔隧道式静脉导管尖端。我们用机械瓣膜假体替换了三尖瓣并重建了右心房。
