Sperlongano Simona, Scognamiglio Giancarlo, D'Andrea Antonello, Golino Paolo
Unit of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy.
Unit of Cardiology and Intensive Coronary Care, "Umberto I" Hospital, Nocera Inferiore, Salerno, Italy.
J Cardiovasc Echogr. 2019 Oct-Dec;29(4):183-184. doi: 10.4103/jcecho.jcecho_59_19.
Aortic location of infective endocarditis is a risk factor for perivalvular extension of infection, even when a native valve is involved. We report the case of a 50-year-old man with a systolic murmur and a history of previous aortic valve infective endocarditis requiring cardiac surgery. A thorough echocardiographic assessment, including three-dimensional transesophageal echocardiography, clearly demonstrated the presence of two distinct postinfective complications, i.e., a fistula of the mitral-aortic intervalvular curtain communicating in systole with the left atrium and an acquired Gerbode-type ventricular septal defect. Our case highlights the pivotal role of echocardiography for a correct and comprehensive diagnostic assessment in the complex scenarios frequently encountered after infective endocarditis.
感染性心内膜炎的主动脉部位是感染向瓣周扩展的危险因素，即使累及的是自身瓣膜。我们报告一例50岁男性患者，有收缩期杂音，既往有主动脉瓣感染性心内膜炎病史，曾接受心脏手术。包括三维经食管超声心动图在内的全面超声心动图评估清楚地显示存在两种不同的感染后并发症，即二尖瓣 - 主动脉瓣间帘状瘘在收缩期与左心房相通以及获得性Gerbode型室间隔缺损。我们的病例突出了超声心动图在感染性心内膜炎后常见复杂情况下进行正确和全面诊断评估中的关键作用。
