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[肱动脉感染性动脉瘤合并感染性二尖瓣心内膜炎的手术经验]

[Surgical Experience of Infective Aneurysm of Brachial Artery Complicated with Infective Mitral Valve Endocarditis].

作者信息

Kikuyama Kaoru, Uchida Tetsuro, Hamasaki Azumi, Kuroda Yoshinori, Yamashita Atsushi, Hayashi Jun, Nakamura Ken, Nakai Shingo, Watanabe Daisuke, Kobayashi Kimihiro, Sadahiro Mitsuaki

机构信息

Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.

出版信息

Kyobu Geka. 2017 May;70(5):348-351.

Abstract

We report a rare case of aneurysmal formation of the left brachial artery complicated with infective endocarditis of the mitral valve. A 67-year-old man was referred to our institution for further examination of pulsatile mass at the left upper extremity. Computed tomography showed a left brachial arterial aneurysm with a diameter of 4 cm and gradual expansion of the aneurysm was also recognized. Furthermore, echocardiography revealed severe mitral valve regurgitation with a vegetation. There was no feature of congestive heart failure. He was diagnosed with subacute infective endocarditis and infective left brachial arterial aneurysm. Considering these clinical findings, staged surgical treatment was planned. He underwent resection of the brachial arterial aneurysm and bypass grafting with an autologous saphenous vein on an urgent basis. One month after the initial operation, elective mitral valve plasty was successfully performed. Although aneurysmal formation of the brachial artery subsequent to infective endocarditis is rare, we should keep this potentially serious complication in mind.

摘要

我们报告一例罕见的左肱动脉动脉瘤形成合并二尖瓣感染性心内膜炎的病例。一名67岁男性因左上肢搏动性肿块前来我院进一步检查。计算机断层扫描显示左肱动脉瘤直径为4 cm,且动脉瘤呈逐渐扩大。此外,超声心动图显示二尖瓣重度反流并伴有赘生物。无充血性心力衰竭表现。他被诊断为亚急性感染性心内膜炎和感染性左肱动脉瘤。考虑到这些临床发现,计划进行分期手术治疗。他紧急接受了肱动脉瘤切除术及自体大隐静脉搭桥术。初次手术后一个月,成功进行了择期二尖瓣成形术。尽管感染性心内膜炎后继发肱动脉瘤形成很罕见,但我们应牢记这一潜在的严重并发症。

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