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植入式中心静脉通路端口装置感染导致的孤立性三尖瓣心内膜炎

Isolated Tricuspid Valve Endocarditis Caused by Infection of an Implanted Central Venous Access Port Device.

作者信息

Aoyagi Shigeaki, Oda Takeshi, Fukuda Hayato, Zaima Yasuyuki, Nakamura Eiji, Yasunaga Hiroshi

机构信息

Department of Cardiovascular Surgery, St. Mary's Hospital.

出版信息

Kurume Med J. 2016;62(1-2):37-40. doi: 10.2739/kurumemedj.MS65009. Epub 2016 Feb 15.

Abstract

A 70-year-old man was referred to our hospital for an intermittent high fever attributed to subcutaneous pocket infection of an implanted central venous access port device caused by methicillin-resistant staphylococcus aureus and subsequent bloodstream infection. Echocardiography revealed a large vegetation on the posterior tricuspid leaflet, annular dilatation and moderate-to-severe tricuspid regurgitation. Valve surgery was performed for persistent infection despite 8 weeks of antibiotics therapy. At operation, vegetations and torn chordae tendineae were found on the posterior tricuspid leaflet. After total resection of the posterior tricuspid leaflet, bicuspidalization valvuloplasty with prosthetic ring annuloplasty was achieved without relapse of the infection or residual regurgitation.

摘要

一名70岁男性因植入式中心静脉通路端口装置皮下囊袋感染(由耐甲氧西林金黄色葡萄球菌引起)及随后的血流感染导致间歇性高热,被转诊至我院。超声心动图显示三尖瓣后叶有一个大的赘生物、瓣环扩张和中重度三尖瓣反流。尽管进行了8周的抗生素治疗,但仍有持续性感染,遂行瓣膜手术。术中发现三尖瓣后叶有赘生物和腱索撕裂。在完全切除三尖瓣后叶后,通过人工瓣环成形术实现了双叶化瓣膜成形术,感染未复发且无残余反流。

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