Di Bacco Lorenzo, Pfeiffer Steffen, Fischlein Theodor J M, Santarpino Giuseppe
From the Department of Cardiac Surgery, Paracelsus Medical University - Klinikum Nürnberg, Nuremberg, Germany.
Innovations (Phila). 2017 Nov/Dec;12(6):483-485. doi: 10.1097/IMI.0000000000000427.
We report a case of infective endocarditis on a Perceval S aortic valve bioprosthesis, and we describe a feasible and useful technique that can help remove the infected valve. These maneuvers consist of an "x-movement" reached with the aid of anatomical forceps. The risk of infective endocarditis in patients with prosthetic valves is a well-known phenomena in cardiac surgery, and it can represent a life-threatening event in many cases. According to guidelines, an emergency surgical intervention is required in case of high risk of embolization, vegetation superior than 1 cm or acute cardiac failure secondary to the acute valve dysfunction. In the reported case, the patient was submitted to emergency surgery because of vegetation with diameter superior to 1 cm on the aortic bioprosthesis. The described "x-movement" technique allowed an easily "en block" excision of the damaged bioprostheses together with vegetation, minimizing the risk of vegetation fragmentation.
我们报告了一例Perceval S主动脉瓣生物假体感染性心内膜炎病例，并描述了一种可行且有用的技术，该技术有助于移除感染的瓣膜。这些操作包括借助解剖钳实现的“X形移动”。人工瓣膜患者发生感染性心内膜炎的风险在心脏外科手术中是一种众所周知的现象，在许多情况下可能是危及生命的事件。根据指南，在发生栓塞高风险、赘生物大于1厘米或急性瓣膜功能障碍继发急性心力衰竭的情况下，需要进行紧急外科干预。在报告的病例中，患者因主动脉生物假体上直径大于1厘米的赘生物而接受了紧急手术。所描述的“X形移动”技术允许轻松地将受损生物假体与赘生物一起“整块”切除，将赘生物碎片的风险降至最低。
