Ishida Shinichi, Fujita Takashi, Yagami Kei, Mutsuga Masato
Department of Cardiac Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
Kyobu Geka. 2020 Oct;73(11):950-953.
A 33-year-old man presenting with fever, fatigue, and delirium was diagnosed with infectious endocarditis(IE). He had already undergone surgery for IE twice;initial valve repair 4 years ago and mitral valve replacement(MVR) 1 year later. He has refractory atopic dermatitis, which was considered to be the cause of his repeated IE. Initially, antibiotics were administered but the infection was not controlled. Therefore, we decided to perform the 3rd surgery. MVR was performed, and using bovine pericardium, we covered valve cuff and suture felts to separete these parts from blood stream. Postoperative echocardiography showed good prosthetic valve motion without transvalvular regurgitation or paravalvular leak. He was discharged on the 39th postoperative day and has been doing well for 2 years since.
一名33岁男性，因发热、乏力和谵妄就诊，被诊断为感染性心内膜炎（IE）。他已经因IE接受过两次手术：4年前首次进行瓣膜修复，1年后进行二尖瓣置换术（MVR）。他患有难治性特应性皮炎，被认为是其反复发生IE的原因。起初给予了抗生素治疗，但感染未得到控制。因此，我们决定进行第三次手术。实施了MVR，并使用牛心包覆盖瓣膜袖口和缝合毡，以使这些部位与血流隔离。术后超声心动图显示人工瓣膜活动良好，无跨瓣反流或瓣周漏。他在术后第39天出院，此后两年情况良好。
