Nakazawa Junji, Naraoka Shuichi, Maeda Toshiyuki, Inoue Satomi
Department of Cardiovascular Surgery, Hokkaido Prefectural Kitami Hospital, Kitami, Japan.
Kyobu Geka. 2013 Dec;66(13):1178-81.
An 83-year-old man had undergone aortic valve replacement (AVR)[CEP Magna 21 mm] and coronary aortic bypass grafting (CABG)[left internal thoracic artery (LITA)-left anterier descending artery( LAD)] 2 years ago in our hospital. He was admitted for fever of unknown origin and developed a stroke to another hospital. The echocardiography and computerized tomography showed an abscessaround the aortic prosthetic valve. Prosthetic valve endocarditis (PVE) was diagnosed, and he was transferred to our hospital for surgical treatment. Three days after admission, acute heart failure developed that led to an emergency operation. When the ascending aorta was dissected, an aorto-left atrium fistula and vegetation were recognized. Aortic valve replacement and patch plasty of the aorto-left atrium fistula were performed successfully. This case was diagnosed as PVE with aorto-left atrium fistula, which is quite a rare complication of PVE.
一名83岁男性两年前在我院接受了主动脉瓣置换术（AVR）[CEP Magna 21毫米]和冠状动脉旁路移植术（CABG）[左胸廓内动脉（LITA）-左前降支动脉（LAD）]。他因不明原因发热入院，随后转至另一家医院并发生了中风。超声心动图和计算机断层扫描显示主动脉人工瓣膜周围有脓肿。诊断为人工瓣膜心内膜炎（PVE），他被转至我院接受手术治疗。入院三天后，出现急性心力衰竭，遂进行急诊手术。解剖升主动脉时，发现了主动脉-左心房瘘和赘生物。成功进行了主动脉瓣置换术和主动脉-左心房瘘修补术。该病例被诊断为伴有主动脉-左心房瘘的PVE，这是PVE相当罕见的一种并发症。
