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[一例双腔右心室合并感染性心内膜炎及三尖瓣反流病例]

[A case of two-chambered right ventricle complicating infective endocarditis and tricuspid regurgitation].

作者信息

Hayase S, Akita T, Ogawa K, Yano Y, Hiramatsu H, Kidokoro H, Hattori T, Suzuki S

出版信息

Kyobu Geka. 1989 Feb;42(2):150-4.

PMID:2733293
Abstract

A 31-year-old male of two-chambered right ventricle with ventricular septal defect, complicating infective endocarditis and tricuspid regurgitation, was presented. Two-dimensional echocardiographic study demonstrated tricuspid vegetations and a hypertrophied, anomalous muscle bundle in the right ventricle. Cardiac catheterization revealed 58 mmHg pressure gradient between inflow chamber and outflow chamber of the right ventricle. It seems that tricuspid regurgitation was resulted from infective endocarditis. He underwent resection of anomalous muscle bundle, repair of ventricular septal defect, and tricuspid valve replacement with satisfactory result. It has not been reported in Japan so far that tricuspid valve replacement was performed for the treatment of tricuspid regurgitation due to infective endocarditis in the patient with two-chambered right ventricle. In our case, cardiac catheterization was performed after subsidence of infective endocarditis. As echocardiography can detect vegetations and anomalous muscle bundle precisely, surgical intervention would be performed without cardiac catheterization in the case of infective endocarditis intractable to medical therapy.

摘要

本文报告了一名31岁男性,患有双腔右心室合并室间隔缺损,并发感染性心内膜炎和三尖瓣反流。二维超声心动图研究显示三尖瓣赘生物以及右心室肥厚的异常肌束。心导管检查显示右心室流入腔和流出腔之间的压力梯度为58 mmHg。三尖瓣反流似乎是由感染性心内膜炎引起的。他接受了异常肌束切除术、室间隔缺损修复术和三尖瓣置换术,并取得了满意的效果。迄今为止,在日本尚未有因感染性心内膜炎导致三尖瓣反流而对双腔右心室患者进行三尖瓣置换术的报道。在我们的病例中,感染性心内膜炎消退后进行了心导管检查。由于超声心动图能够精确检测赘生物和异常肌束,对于药物治疗难以控制的感染性心内膜炎病例,无需进行心导管检查即可进行手术干预。

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