采用无缝合Perceval S瓣膜进行主动脉瓣置换术：一例在星座链球菌性心内膜炎背景下主动脉根部同种异体移植物失败的病例报告。
Aortic valve replacement with sutureless Perceval S valve: A case report of aortic root homograft failure in the setting of Streptococcus constellatus endocarditis.
作者信息
Hammond Rory F L, Jasionowska Sara, Awad Wael I
机构信息
Department of Cardiothoracic Surgery, Barts Heart Centre, St. Bartholomew's Hospital, London, UK.
出版信息
J Card Surg. 2020 Oct;35(10):2829-2831. doi: 10.1111/jocs.14846. Epub 2020 Jul 17.
BACKGROUND
Surgery for failed homograft aortic root replacement with extensive calcification in the setting of endocarditis alone is very challenging.
CASE SUMMARY
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.
DISCUSSION
We consider heavily calcified failed homografts to be a good indication for sutureless (rapid deployment) valves.
背景
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。
病例摘要
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。
讨论
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。
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