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经导管肺动脉瓣植入术后患者的感染性心内膜炎

Infective Endocarditis in a Patient with Transcatheter Pulmonary Valve Implantation.

作者信息

Wang Cheng, Li Yan-Jie, Ma Lan, Pan Xin

机构信息

Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University.

出版信息

Int Heart J. 2019 Jul 27;60(4):983-985. doi: 10.1536/ihj.18-497. Epub 2019 Jun 28.

Abstract

Infective endocarditis (IE) is a lethal complication inpatients with congenital heart disease. We report a case of percutaneous implanted pulmonary valve IE in a 49-year-old female. She underwent a previous surgery for tetralogy of Fallot with transannular patching of the right ventricular outflow tractat the age of 18 years. Echocardiography showed chronic moderate to severe pulmonary regurgitation with right heart enlargement. She underwent transcatheter pulmonary valve implantation with a 26 mm Venus-P valve (Venus Medtech, Shanghai, China) in order to release pulmonary insufficiency. Two months after implantation, she presented with recurrent chills and febrile for one week, and percutaneous implanted pulmonary valve IE was diagnosed. According to the antibiotic susceptibility test, she was given penicillin and gentamycin. At 12 months follow-up, TTE showed vegetation completely disappeared and the valve functioned normally. The patient recovered uneventfully without any complications like recurrent IE.

摘要

感染性心内膜炎(IE)是先天性心脏病患者的一种致命并发症。我们报告一例49岁女性经皮植入肺动脉瓣感染性心内膜炎的病例。她曾在18岁时因法洛四联症接受手术,对右心室流出道进行了跨环补片。超声心动图显示慢性中度至重度肺反流伴右心扩大。为缓解肺功能不全,她接受了经导管肺动脉瓣植入术,植入一枚26mm的Venus-P瓣膜(Venus Medtech,中国上海)。植入术后两个月,她出现反复寒战和发热一周,被诊断为经皮植入肺动脉瓣感染性心内膜炎。根据药敏试验,给予她青霉素和庆大霉素。随访12个月时,经胸超声心动图(TTE)显示赘生物完全消失,瓣膜功能正常。患者恢复顺利,未出现复发性感染性心内膜炎等任何并发症。

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