Shinonaga Mayumi, Kuraoka Setsuo, Tatebe Shoh, Chiba Yoshiro, Ohhira Kouji, Fukunaga Hiroshi, Yamashita Fumio, Aizawa Akira, Murata Minoru
Department of Cardiovascular Surgery and Thoracic Surgery, Mito Saiseikai General Hospital, Mito, Japan.
Kyobu Geka. 2013 Aug;66(9):806-9.
A 30-year-old woman with a more than 6-month history of fever, weight loss, general fatigue and dysesthesia of lower extremities was admitted to our hospital with a diagnosis of infective endocarditis. Blood cultures revealed Staphylococcus oralis. Echocardiography revealed severe mitral and moderate tricuspid regurgitation, as well as massive vegetations and aneurysms on the mitral valve. Computed tomography revealed an abdominal aortic aneurysm, left common and external iliac arterial aneurysms, and occlusion of the left common iliac, the deep femoral arteries and the bilateral tibioperoneal trunk. The ankle brachial pressure indices (ABI) were 0.94 (right) and 0.61 (left). She initially underwent mitral valve replacement and tricuspid annuloplasty. On postoperative day 24, the affected segments of the arteries were replaced with a woven Dacron bifurcated graft after resection of the mycotic abdominal and the iliac arterial aneurysms. We could not obtain a sufficient amount of omental pedicle to wrap the prosthesis. Her postoperative course was uneventful and mycotic arterial embolism and aneurysm did not recur.
一名30岁女性，有超过6个月的发热、体重减轻、全身乏力及下肢感觉异常病史，因感染性心内膜炎入院。血培养显示为口腔葡萄球菌。超声心动图显示重度二尖瓣反流和中度三尖瓣反流，以及二尖瓣上有大量赘生物和动脉瘤形成。计算机断层扫描显示腹主动脉瘤、左髂总动脉和髂外动脉瘤，以及左髂总动脉、股深动脉和双侧胫腓干闭塞。踝肱压力指数（ABI）分别为0.94（右侧）和0.61（左侧）。她最初接受了二尖瓣置换术和三尖瓣环成形术。术后第24天，在切除感染性腹主动脉瘤和髂动脉瘤后，用编织涤纶分叉移植物替换了受累动脉段。我们未能获取足够量的网膜蒂来包裹假体。她术后恢复顺利，感染性动脉栓塞和动脉瘤未复发。
