University of Kentucky, Lexington, KY, USA.
Semin Cardiothorac Vasc Anesth. 2021 Mar;25(1):57-61. doi: 10.1177/1089253220952260. Epub 2020 Aug 27.
Tricuspid valve infective endocarditis is an increasingly common sequela of the opioid epidemic. While often managed medically, certain subsets of patients will require surgical intervention, including repair, replacement, and possibly even excision. Historically, simple valvectomy was performed in instances of recidivism and reinfection; however, reoperation and replacement has become the preferred treatment in the current era. Given the increasing incidence of intravenous drug use and the increase in the number of patients presenting with recurrent infections, simple valvectomy has regained favor in recent years. In this article, we present the management of a critically ill patient with recurrent tricuspid valve endocarditis who underwent tricuspid valvectomy that was complicated by a left ventricle to right atrium fistula and discuss some of the most important perioperative issues and complications for patients who undergo tricuspid valvectomy.
三尖瓣感染性心内膜炎是阿片类药物流行的一种越来越常见的后遗症。虽然通常采用药物治疗,但某些特定患者群体需要手术干预,包括修复、替换,甚至可能切除。在过去,对于复发和再感染的情况,通常会进行单纯的瓣叶切除术;然而,在当前时代,再次手术和替换已成为首选治疗方法。由于静脉内药物使用的发生率增加以及反复感染的患者数量增加,近年来单纯的瓣叶切除术又重新受到青睐。在本文中,我们介绍了一位患有复发性三尖瓣心内膜炎的重症患者的治疗情况,该患者接受了三尖瓣切除术,术后并发左心室至右心房瘘,我们还讨论了行三尖瓣切除术患者最重要的围手术期问题和并发症。