Toba Shuhei, Ito Hisato, Futsuki Ayano, Yamamoto Naoki, Konuma Takeshi, Takao Motoshi, Ogihara Yoshito, Shimpo Hideto
Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie Prefecture, 514-8507, Japan.
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie Prefecture, 514-8507, Japan.
Gen Thorac Cardiovasc Surg. 2020 Aug;68(8):858-861. doi: 10.1007/s11748-019-01193-5. Epub 2019 Aug 26.
Infective endocarditis is one of the complications encountered in patients with uncorrected tetralogy of Fallot; however, there have been only limited reports on surgical treatment of this condition. A 38-year-old man with uncorrected tetralogy of Fallot with pulmonary atresia previously palliated with modified Blalock-Taussig shunt was diagnosed with aortic valve infective endocarditis and developed severe aortic regurgitation. He underwent urgent aortic valve replacement, during which intermittent hypothermic circulatory arrest was necessary to achieve adequate myocardial protection and bloodless surgical field due to massive arterial return into the left ventricle from the collateral pulmonary circulation.
感染性心内膜炎是法洛四联症未矫治患者所面临的并发症之一；然而，关于该病症外科治疗的报道有限。一名38岁男性，患有法洛四联症且伴有肺动脉闭锁，此前接受改良布莱洛克 - 陶西格分流术姑息治疗，被诊断为主动脉瓣感染性心内膜炎并出现严重主动脉瓣反流。他接受了紧急主动脉瓣置换术，在此过程中，由于来自肺循环侧支的大量动脉血回流至左心室，需要间歇性低温循环停搏以实现充分的心肌保护和无血手术视野。
