Wedin Johan O, Janiec Mikael, Schiller Petter
Department Surgical Sciences, Division of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden.
J Surg Case Rep. 2020 Aug 24;2020(8):rjaa079. doi: 10.1093/jscr/rjaa079. eCollection 2020 Aug.
The indication for transcatheter aortic valve implantation (TAVI) is continuously expanding with a simultaneous increase in number of TAVI associated prosthetic valve endocarditis (TAVI-PVE). Evidence for management of TAVI-PVE is lacking but the need for surgical management of complex TAVI-PVE is expected to increase. The Commando procedure, a technically challenging surgery for treatment of complex endocarditis, has never been described in a patient with TAVI-PVE. An 80-year-old female with TAVI-PVE, native mitral valve endocarditis and an abscess in the intervalvular fibrous body was admitted to our clinic. She successfully underwent the Commando procedure with implantation of biological mitral and aortic valve prostheses and reconstruction of the intervalvular fibrous body. We demonstrate that the Commando procedure is a feasible surgical alternative in patients with TAVI-PVE and that it can be considered in patients with high surgical risk.
经导管主动脉瓣植入术（TAVI）的适应证在不断扩大，与此同时，TAVI相关人工瓣膜心内膜炎（TAVI-PVE）的病例数也在增加。目前缺乏TAVI-PVE治疗的相关证据，但预计复杂TAVI-PVE的外科治疗需求将会增加。“突击手术”是一种技术上具有挑战性的治疗复杂性心内膜炎的手术，此前从未在TAVI-PVE患者中描述过。一名80岁患有TAVI-PVE、原发性二尖瓣心内膜炎且瓣间纤维体有脓肿的女性患者入住我院。她成功接受了“突击手术”，植入了生物二尖瓣和主动脉瓣人工瓣膜，并重建了瓣间纤维体。我们证明，“突击手术”对于TAVI-PVE患者是一种可行的手术选择，对于手术风险高的患者也可考虑采用。
