Kobayashi Masaaki, Higashiue Shinichi, Kuroyanagi Satoshi, Furuya Onichi, Hiramatsu Norihiko, Matsuura Makoto, Kasuga Kensuke, Takemoto Tetsushi, Ishidou Kouhei
Department of Cardiovascular Surgery, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
Kyobu Geka. 2021 Nov;74(12):1020-1023.
We report a rare case of isolated pulmonary valve endocarditis in a 60-year-old man without congenital heart defects. He had a persistent fever and back neck pain after pulling out his teeth. Echo cardiography revealed a mobile vegetation (measuring 53 mm in size) adhering to the pulmonary valve and blood cultures showed the presence of Staphylococcus aureus( S. aureus). Because of mobile vegetation, pulmonic embolism and presence of S. aureus, surgical treatment was selected. During surgical procedure, we found that the vegetation had destroyed markedly pulmonary valve leaflets. After excising pulmonary valve leaflets, we implanted a bioprosthetic valve and enlarged the pulmonary artery with autologous pericardium. A year after surgery, the patient is stable with no sign of infection.
我们报告了一例罕见的孤立性肺动脉瓣心内膜炎病例，患者为一名60岁男性，无先天性心脏缺陷。他拔牙后持续发热并伴有颈背部疼痛。超声心动图显示一个活动的赘生物（大小为53毫米）附着在肺动脉瓣上，血培养显示存在金黄色葡萄球菌。由于存在活动的赘生物、肺栓塞以及金黄色葡萄球菌感染，故选择手术治疗。在手术过程中，我们发现赘生物已显著破坏肺动脉瓣叶。切除肺动脉瓣叶后，我们植入了一个生物人工瓣膜，并用自体心包扩大了肺动脉。术后一年，患者情况稳定，无感染迹象。
