Hammond Rory F L, Jasionowska Sara, Awad Wael I
Department of Cardiothoracic Surgery, Barts Heart Centre, St. Bartholomew's Hospital, London, UK.
J Card Surg. 2020 Oct;35(10):2829-2831. doi: 10.1111/jocs.14846. Epub 2020 Jul 17.
Surgery for failed homograft aortic root replacement with extensive calcification in the setting of endocarditis alone is very challenging.
We report the case of redo aortic valve replacement and mitral valve replacement, in a 39 years old presenting with a rare Streptococcus constellatus endocarditis of a previously implanted homograft root and native mitral valve, where conventional valve replacement proved nonfeasible. S. constellatus had caused severe tissue destruction and the extensive calcification in the homograft prevented conventional valve replacement with sutures. In this case, a sutureless valve provided a useful alternative surgical strategy.
We consider heavily calcified failed homografts to be a good indication for sutureless (rapid deployment) valves.
对于单纯感染性心内膜炎导致的同种异体主动脉根部置换失败且伴有广泛钙化的情况，手术极具挑战性。
我们报告了一例39岁患者再次行主动脉瓣置换和二尖瓣置换的病例，该患者患有罕见的星座链球菌性心内膜炎，累及先前植入的同种异体主动脉根部和自身二尖瓣，传统瓣膜置换术不可行。星座链球菌导致了严重的组织破坏，同种异体移植物中的广泛钙化使得无法用缝线进行传统瓣膜置换。在此病例中，无缝线瓣膜提供了一种有效的替代手术策略。
我们认为严重钙化的失败同种异体移植物是无缝线（快速植入）瓣膜的良好适应证。
