Hatori Kyohei, Ohki Satoshi, Obayashi Tamiyuki, Yasuhara Kiyomitsu, Hirai Hanako, Miki Takao
Department of Cardiovascular Surgery, Isesaki Municipal Hospital, 12-1 Tsunatori-honmachi, Isesaki, Gunma, 372-0812, Japan.
Gen Thorac Cardiovasc Surg. 2018 Apr;66(4):235-238. doi: 10.1007/s11748-017-0788-7. Epub 2017 Jun 6.
We report a case of isolated pulmonary valve endocarditis in a 47-year-old woman without predisposing factors. She had episodes of low-grade fever and non-productive cough and was initially diagnosed with bacterial pneumonia. With antibiotic treatment, her condition improved transiently, but she had repeated respiratory events. Forty days after her first visit, she complained of severe dyspnea. Echocardiography revealed a large vegetation adhering to the pulmonary valve and she was diagnosed with isolated pulmonary valve endocarditis. Surgical treatment was selected because antibiotic treatment was not effective. The main pulmonary artery was transected above the annulus and the infected valve was excised. To avoid contact of the prosthetic valve with the infected pulmonary annulus, a stentless bioprosthesis was interposed between the transected parts of the pulmonary trunk. Two years after the surgery, the patient is stable with no sign of infection.
我们报告一例47岁无易感因素的女性孤立性肺动脉瓣心内膜炎病例。她有低热和干咳发作，最初被诊断为细菌性肺炎。经过抗生素治疗，她的病情暂时好转，但反复出现呼吸道症状。首次就诊40天后，她主诉严重呼吸困难。超声心动图显示一个大的赘生物附着在肺动脉瓣上，她被诊断为孤立性肺动脉瓣心内膜炎。由于抗生素治疗无效，选择了手术治疗。在瓣环上方横断主肺动脉，切除感染的瓣膜。为避免人工瓣膜与感染的肺动脉瓣环接触，在肺动脉干横断部位之间置入一个无支架生物假体。手术后两年，患者情况稳定，无感染迹象。
