Hama Gentaku, Okada Yoshiharu, Tsuda Yasutoshi, Shiratori Kazuaki, Takemura Takahiro
Department of Cardiovascular Surgery, Saku Central Hospital, Saku, Japan.
Kyobu Geka. 2013 Jun;66(6):497-500.
We report a surgical case of prosthetic valve endocarditis( PVE) after aortic valve replacement with a Freestyle stentless bioprosthesis, which was successfully treated with full root replacement using a Freestyle valve. A 80-year-old man underwent aortic valve replacement with a Freestyle stentless bioprosthesis, using subcoronary technique for aortic stenosis in 2004. Three years later he had late PVE, and we found the aortic-root pseudoaneurysm. Although homografts are the optimal for cases of severe aortic annular destruction, availability of these are limited in Japan. We chose a Freestyle valve with full root technique, which fitted well to the destroyed annulus. The postoperative course was uneventful. Freestyle stentless bioprosthesis can be useful option for PVE, meanwhile care should be taken to dead cavity between prosthesis and aortic wall in the subcoronary technique.
我们报告了1例在使用Freestyle无支架生物瓣膜进行主动脉瓣置换术后发生人工瓣膜心内膜炎（PVE）的外科病例，该病例通过使用Freestyle瓣膜进行全根部置换成功治愈。一名80岁男性于2004年因主动脉瓣狭窄采用冠状动脉下技术，使用Freestyle无支架生物瓣膜进行了主动脉瓣置换。三年后他发生了晚期PVE，我们发现了主动脉根部假性动脉瘤。尽管同种异体移植物是严重主动脉瓣环破坏病例的最佳选择，但在日本这些移植物的可用性有限。我们选择了采用全根部技术的Freestyle瓣膜，其与破坏的瓣环适配良好。术后过程顺利。Freestyle无支架生物瓣膜对于PVE可能是一种有用的选择，同时在冠状动脉下技术中应注意假体与主动脉壁之间的死腔。
