Sicaja Mario, Baric Davor, Unic Daniel, Marusic Srecko, Vincelj Josip, Sicaja Maria Nicole, Starcevic Boris
Ms. Mario Sicaja ., Department of Cardiology,, Clinical Hospital Dubrava,, Av Gojka Suska6 I.kat Zagreb 1000, Croatia, T: +385 1 290 2420, F: +385 1 286 3652,
Ann Saudi Med. 2015 Nov-Dec;35(6):472-4. doi: 10.5144/0256-4947.2015.472.
Prosthetic valve endocarditis (PVE) is the most feared complication after valve implantation. It usually results in substantial morbidity and mortality in the postoperative period. An adverse effect on the annulus can cause conduction disturbances in the atrioventricular (AV) node, resulting in a high-degree AV block. This study describes a case of PVE that predominantly presented with sustained monomorphic ventricular tachycardia, which indicated a severe clinical course of PVE caused by a significant displacement of the aortic valve prosthesis. In our opinion, a very pronounced flap valve motion of the dehisced valve probably caused, in the critical moment, coronary artery blood flow limitation by means of coronary microembolization, which produced temporary ischemia and provoked sustained ventricular tachycardia. Furthermore, disturbances of rhythm such as ventricular tachycardia in the setting of endocarditis indicate a high-risk condition and should mandate fast and thorough noninvasive diagnostic procedures to obtain correct diagnosis even in the case of mild, slowly progressing disease.
人工瓣膜心内膜炎（PVE）是瓣膜植入后最可怕的并发症。它通常会在术后导致严重的发病和死亡。对瓣环的不良影响可引起房室（AV）结传导障碍，导致高度房室传导阻滞。本研究描述了一例主要表现为持续性单形性室性心动过速的PVE病例，这表明主动脉瓣人工瓣膜明显移位导致了PVE的严重临床过程。我们认为，裂开瓣膜的瓣叶运动非常明显，可能在关键时刻通过冠状动脉微栓塞导致冠状动脉血流受限，产生暂时性缺血并引发持续性室性心动过速。此外，心内膜炎情况下的心律失常如室性心动过速表明是高危情况，即使在疾病轻微、进展缓慢的情况下，也应要求进行快速、彻底的非侵入性诊断程序以获得正确诊断。
