Sage M D, Koelmeyer T D, Smeeton W M, Galler L L
Department of Pathology, University of Auckland, New Zealand.
Am J Forensic Med Pathol. 1988 Jun;9(2):112-8. doi: 10.1097/00000433-198806000-00005.
Invasive resuscitative and supportive therapy subsequent to accidental trauma, assault, or medical mishap may create lesions that forensic pathologists must interpret. Pulmonary valve nonbacterial endocarditis sometimes complicates placement of flow-directed pulmonary artery (Swan-Ganz) catheters. We examined ten cases of endocarditis from patients dying 0-10 days after removal of a Swan-Ganz catheter, and compared the natural evolution of vegetations in critically ill patients with the reported evolution of similar vegetations in experimental animals in the Freedman model. There was wide variation in macroscopic, as well as in the light- and scanning electron-microscopic, appearances in our cases and we could not establish a direct relationship between vegetation structure and time elapsed after removal of the catheter. These findings suggest that parameters related to critical illness and species account for the differences between this disease in human and animal models.
意外创伤、袭击或医疗事故后的侵入性复苏和支持性治疗可能会造成一些损伤，法医病理学家必须对这些损伤进行解读。肺动脉瓣非细菌性心内膜炎有时会使血流导向肺动脉（Swan-Ganz）导管的放置变得复杂。我们检查了10例在拔除Swan-Ganz导管后0至10天内死亡患者的心内膜炎病例，并将重症患者赘生物的自然演变过程与Freedman模型中实验动物类似赘生物的报道演变过程进行了比较。我们的病例在宏观、光镜和扫描电镜表现上存在很大差异，并且我们无法确定赘生物结构与拔除导管后经过时间之间的直接关系。这些发现表明，与危重病和物种相关的参数导致了人类和动物模型中这种疾病的差异。
