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一名依赖透析的终末期肾衰竭患者因鲍曼不动杆菌导致活动性感染性心内膜炎并伴有主动脉根部脓肿而行急诊心脏双瓣膜手术：一例罕见病例报告

Emergency cardiac double valve surgery in active infective endocarditis due to Acinetobacter baumannii with aortic root abscess in a patient with dialysis-dependent end-stage renal failure: a rare case report.

作者信息

Kunhi Moosa, Sanagar Sachin, Jagadeesh N, Shankar Bhima, Abraham Abi

机构信息

Department of Cardiothoracic & Vascular Surgery, Lakeshore Hospital and Research Centre, Kochi, Kerala, India

Department of Cardiothoracic & Vascular Surgery, Lakeshore Hospital and Research Centre, Kochi, Kerala, India.

出版信息

J Surg Case Rep. 2016 Dec 2;2016(12):rjw168. doi: 10.1093/jscr/rjw168.

DOI:10.1093/jscr/rjw168
PMID:27915239
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5159179/
Abstract

We report an end-stage renal disease (ESRD) patient on regular haemodialysis awaiting renal transplant having native aortic valve endocarditis due to Acinetobacter baumannii complicated with aortic root abscess and severe mitral valve regurgitation with NYHA class IV symptoms. He underwent emergency aortic root abscess debridement, reconstruction with autologous pericardial patch and bioprosthetic aortic valve replacement along with mitral valve repair. This emergency intervention in active infective endocarditis due to A. baumannii and associated ESRD is very rare. We could not trace any case report for such combination of clinical scenario in the literature.

摘要

我们报告了一名终末期肾病（ESRD）患者，该患者正在接受定期血液透析，等待肾移植，患有鲍曼不动杆菌引起的自体主动脉瓣心内膜炎，并伴有主动脉根部脓肿和严重二尖瓣反流，纽约心脏协会（NYHA）心功能分级为IV级。他接受了紧急主动脉根部脓肿清创术、自体心包补片重建和生物人工主动脉瓣置换术以及二尖瓣修复术。这种针对鲍曼不动杆菌引起的活动性感染性心内膜炎及相关ESRD的紧急干预非常罕见。我们在文献中未能找到任何关于这种临床情况组合的病例报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2606/5159179/d776dcf0b320/rjw168f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2606/5159179/91d92e5e5b9a/rjw168f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2606/5159179/788d24817480/rjw168f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2606/5159179/d776dcf0b320/rjw168f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2606/5159179/91d92e5e5b9a/rjw168f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2606/5159179/788d24817480/rjw168f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2606/5159179/d776dcf0b320/rjw168f03.jpg

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本文引用的文献

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Long-term survival of dialysis patients with bacterial endocarditis undergoing valvular replacement surgery in the United States.美国接受瓣膜置换手术的透析患者细菌性心内膜炎的长期生存情况。
Circulation. 2013 Jul 23;128(4):344-51. doi: 10.1161/CIRCULATIONAHA.113.002365. Epub 2013 Jun 19.
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Double valve replacement and reconstruction of the intervalvular fibrous body in patients with active infective endocarditis.在活动性感染性心内膜炎患者中进行双瓣置换和瓣下纤维体重建。
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在人工主动脉瓣心内膜炎情况下由停乳链球菌引起的瓣周假性动脉瘤。
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