Department of Cardio-Thoracic and Vascular Surgery, France.
Department of Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; CIC Inserm 0203, Rennes-1 University, France.
Clin Microbiol Infect. 2015 Apr;21(4):371.e1-4. doi: 10.1016/j.cmi.2014.11.027. Epub 2014 Dec 11.
This study reports six consecutive patients who underwent heart transplantation as salvage treatment for endocarditis (Duke criteria) with extensive perivalvular lesions and end-stage heart failure. The median age was 45 years (range, 24 to 64), and the aortic valve was affected in all patients. Pathogens were Staphylococcus aureus (n = 2), Streptococcus pneumoniae (n = 2), Streptococcus agalactiae (n = 1), or not documented (n = 1). All patients survived, with no relapse, after a median follow-up of 24.5 months. The 10 patients with heart transplantation for endocarditis previously reported also survived (median follow-up, 27.5 months). Heart transplantation may be considered as salvage treatment in selected patients with intractable infective endocarditis.
本研究报告了 6 例连续患者，他们因感染性心内膜炎（杜克标准）伴广泛瓣周病变和终末期心力衰竭而行心脏移植作为挽救治疗。中位年龄为 45 岁（范围 24 至 64 岁），所有患者的主动脉瓣均受累。病原体分别为金黄色葡萄球菌（n=2）、肺炎链球菌（n=2）、无乳链球菌（n=1）或未记录（n=1）。所有患者在中位随访 24.5 个月后均存活，无复发。此前报告的 10 例因心内膜炎而行心脏移植的患者也存活（中位随访时间 27.5 个月）。心脏移植可作为难治性感染性心内膜炎患者的挽救治疗手段。
