Kikuchi Yuta, Kikuchi Yoichi, Atsuta Yoshiaki, Tsutsui Masahiro
Department of Cardiovascular Surgery, Obihiro Hospital, Obihiro, Japan.
Kyobu Geka. 2020 Apr;73(4):312-315.
There have been few reports about degenerated monocusp-valve patches, which were used for right ventricular outflow tract( RVOT) reconstruction with complications of infective endocarditis after total correction of tetralogy of Fallot( TOF).A 44-year-old male patient, who had a total correction of TOF using Monocusp Valved Outflow Patch (MVOP) 34 years previous, was admitted for heart failure with aortic regurgitation. An echocardiographic study showed an infective endocarditis with vegetations, attached to the aortic valve and the monocusp-valve outflow patch. The aortic valve was replaced with a mechanical prosthesis and the pulmonary valve was replaced with a biological prosthesis. RVOT was reconstructed using a bovine pericardial patch. The explanted monocusp-valve was deteriorated and heavily calcified. The postoperative course was uneventful. The patient was discharged and returned to his preoperative lifestyle 36 days after the redo surgery.
关于退化的单叶瓣膜补片的报道很少，这些补片用于法洛四联症（TOF）完全矫正术后右心室流出道（RVOT）重建，伴有感染性心内膜炎并发症。一名44岁男性患者，34年前使用单叶带瓣流出道补片（MVOP）对TOF进行了完全矫正，因主动脉瓣反流导致心力衰竭入院。超声心动图研究显示感染性心内膜炎伴有赘生物，附着于主动脉瓣和单叶瓣膜流出道补片。主动脉瓣被机械瓣膜置换，肺动脉瓣被生物瓣膜置换。RVOT使用牛心包补片重建。取出的单叶瓣膜已退化并严重钙化。术后过程顺利。患者在再次手术后36天出院，恢复到术前的生活方式。
