Pozsonyi Zoltán, Benedek Szabolcs, Sármán Pál, Jánoskuti Lívia, Hüttl Tivadar, Apor Astrid
3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
Heart Center, Semmelweis University, Budapest, Hungary. Electronic correspondence:
J Heart Valve Dis. 2016 Nov;25(6):752-755.
Endomyocardial fibrosis (EMF) is the most common cardiac abnormality in hyeperosinophilic syndrome (HES), sometimes complicated with mitral valve disease. Mitral valve disease without ventricular manifestation is very rare, however. Case reports link HES to prosthetic valve thrombosis (PVT), but the optimal type of prosthetic valve in HES is not known. Herein is reported the case of a young female HES patient with secondary mitral valve degeneration and severe regurgitation. A mechanical prosthetic valve was implanted six months after she was diagnosed with HES, but despite anticoagulation and antiplatelet therapy she developed PVT three months later. Partially successful thrombolysis was followed by biological prosthetic valve implantation, with no further complications during the subsequent four years. The eosinophil count and treatment for HES was basically unchanged during the follow up period, following the initiation of treatment. Based on these findings it is suggested that, in HES, the implantation of a biological prosthetic valve might be preferable over a mechanical valve.
心内膜心肌纤维化（EMF）是嗜酸性粒细胞增多综合征（HES）中最常见的心脏异常，有时并发二尖瓣疾病。然而，无心室表现的二尖瓣疾病非常罕见。病例报告将HES与人工瓣膜血栓形成（PVT）联系起来，但HES中最佳的人工瓣膜类型尚不清楚。本文报道了一例年轻女性HES患者，继发二尖瓣退变并严重反流。在她被诊断为HES六个月后植入了机械人工瓣膜，但尽管进行了抗凝和抗血小板治疗，三个月后她仍发生了PVT。部分成功的溶栓治疗后植入了生物人工瓣膜，随后四年未出现进一步并发症。随访期间，嗜酸性粒细胞计数和HES治疗在开始治疗后基本未变。基于这些发现，提示在HES中，植入生物人工瓣膜可能比机械瓣膜更可取。
