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肺动脉部位感染性心内膜炎的外科治疗——单中心15年经验

Surgical Treatment of Infective Endocarditis in Pulmonary Position-15 Years Single Centre Experience.

作者信息

Liekiene Daina, Bezuska Laurynas, Semeniene Palmyra, Cypiene Rasa, Lebetkevicius Virgilijus, Tarutis Virgilijus, Barysiene Jurate, Rucinskas Kestutis, Sirvydis Vytautas

机构信息

Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania.

出版信息

Medicina (Kaunas). 2019 Sep 19;55(9):608. doi: 10.3390/medicina55090608.

Abstract

: Infective endocarditis in the pulmonary position is a rare disease. Isolated pulmonary valve endocarditis is extremely rare. The aim of our study was to assess patients who were treated surgically for pulmonary endocarditis at our institution from January 2003 to December 2017. : We analyze eight cases of infectious endocarditis in pulmonary position out of 293 patients who were operated for infective endocarditis (2.7%, 8/293). Only two of these eight patients were not related to congenital heart malformation. They were followed for early and late mortality, long-term survival, postoperative morbidity and reoperations. : Among six patients suffering from congenital heart disease, four patients underwent corrections of pulmonary valve malformation previously, and their infected grafts were replaced by two allografts and two xenografts. The two other patients had replaced their infected pulmonary valves with allografts. Two non-congenital patients with pulmonary valve endocarditis underwent valve replacement with biological prosthesis. All patients survived the early postoperative course. The mean follow-up time was 9.1 (interquartile range (IQR), 5.3-12.6) years. The long-term follow-up included seven patients. One patient (12.5%, 1/8) died more than 4 years after the surgery due to sepsis. Pulmonary endocarditis was the rarest endocarditis treated surgically ( < 0.001). : Surgery for infective endocarditis in the pulmonary position (IEPP) is an effective method of treatment with excellent early outcome and good late results despite a very uncommon pathology and few operations being performed. Surgery performed earlier may make the procedure less radical.

摘要

肺位感染性心内膜炎是一种罕见疾病。孤立性肺动脉瓣心内膜炎极为罕见。我们研究的目的是评估2003年1月至2017年12月期间在我院接受手术治疗的肺性心内膜炎患者。:我们分析了293例因感染性心内膜炎接受手术的患者中的8例肺位感染性心内膜炎病例(2.7%,8/293)。这8例患者中只有2例与先天性心脏畸形无关。对他们进行了早期和晚期死亡率、长期生存率、术后发病率及再次手术情况的随访。:在6例患有先天性心脏病的患者中,4例先前接受过肺动脉瓣畸形矫正术,其感染的移植物分别被2个同种异体移植物和2个异种移植物所替代。另外2例患者用同种异体移植物替换了感染的肺动脉瓣。2例非先天性肺动脉瓣心内膜炎患者接受了生物假体瓣膜置换术。所有患者术后早期均存活。平均随访时间为9.1(四分位间距(IQR),5.3 - 12.6)年。长期随访包括7例患者。1例患者(12.5%,1/8)术后4年多因败血症死亡。肺性心内膜炎是手术治疗的最罕见的心内膜炎(<0.001)。:肺位感染性心内膜炎(IEPP)手术是一种有效的治疗方法,尽管病理情况非常罕见且手术例数很少,但早期效果极佳,晚期结果良好。早期进行手术可能会使手术操作不那么彻底。

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