利布曼-萨克斯心内膜炎患者二尖瓣和主动脉瓣反流的双瓣膜置换术

Double-valve replacement for mitral and aortic regurgitation in a Patient with Libman-Sacks endocarditis.

作者信息

Hachiya Kenta, Wakami Kazuaki, Tani Tomomitsu, Yoshida Atsuhiro, Suzuki Shugo, Suda Hisao, Ohte Nobuyuki

机构信息

Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Japan.

出版信息

Intern Med. 2014;53(16):1769-73. doi: 10.2169/internalmedicine.53.2232. Epub 2014 Aug 15.

DOI:10.2169/internalmedicine.53.2232

PMID:25130108

Abstract

A 53-year-old woman with systemic lupus erythematosus and antiphospholipid syndrome presented with central nervous system (CNS) lupus and vegetation of the mitral and aortic valves. Her CNS lupus was relieved with methylprednisolone pulse therapy; however, her mitral regurgitation worsened, and she developed acute decompensated heart failure. The mitral and aortic valves were replaced with mechanical heart valves. Microscopic examination of the excised valves showed no bacterial invasion, and Libman-Sacks (LS) endocarditis of both valves was confirmed. This was a case of LS endocarditis with clear vegetation that spread over the mitral and aortic valves.

摘要

一名53岁患有系统性红斑狼疮和抗磷脂综合征的女性，出现中枢神经系统（CNS）狼疮以及二尖瓣和主动脉瓣赘生物。她的中枢神经系统狼疮通过甲泼尼龙冲击疗法得到缓解；然而，她的二尖瓣反流加重，并且发展为急性失代偿性心力衰竭。二尖瓣和主动脉瓣被机械心脏瓣膜置换。对切除瓣膜的显微镜检查未发现细菌侵袭，确诊为两个瓣膜均有Libman-Sacks（LS）心内膜炎。这是一例伴有明确赘生物的LS心内膜炎，赘生物蔓延至二尖瓣和主动脉瓣。