Chen Mei-Ling, Chen Michael Y, Yin Wei-Hsian, Wei Jeng, Wang Ji-Hung
Department of Internal Medicine; ; Buddhist Tzu Chi University, Hualien;
Department of Cardiology, Buddhist Tzu Chi General Hospital; ; Buddhist Tzu Chi University, Hualien;
Acta Cardiol Sin. 2014 Jul;30(4):341-5.
The Bentall procedure is the gold standard for treating aortic dissection complicated with valvular and ascending aorta disease. Recent results for this procedure have been excellent; nearly 100% of patients remain free of infective endocarditis in long-term follow-up. We report a case of delayed Streptococcus agalactiae infective endocarditis complicated by mycotic aneurysm in a man who had undergone the Bentall procedure with a mechanical valve conduit 15 years previously. The mycotic aneurysm was located in the remnant aortic root, below the mechanical valve conduit, and later ruptured into the right atrium. The patient was treated conservatively and survived the acute period. Later, the aortic root defect was repaired successfully by means of a hybrid technique using a Amplatzer duct occluder.
Amplatzer duct occluder; Aortic dissection; Bentall technique; Infective endocarditis; Mycotic aneurysm.
Bentall手术是治疗合并瓣膜及升主动脉疾病的主动脉夹层的金标准。该手术近期效果极佳；长期随访中近100%的患者未发生感染性心内膜炎。我们报告1例15年前接受带机械瓣膜管道的Bentall手术的男性患者发生迟发性无乳链球菌感染性心内膜炎并合并霉菌性动脉瘤。霉菌性动脉瘤位于机械瓣膜管道下方的残余主动脉根部，随后破裂进入右心房。患者接受了保守治疗并度过急性期。后来，采用Amplatzer封堵器通过杂交技术成功修复了主动脉根部缺损。
Amplatzer封堵器；主动脉夹层；Bentall技术；感染性心内膜炎；霉菌性动脉瘤。
