Tominaga Yuji, Ueno Takayoshi, Taira Masaki, Miyagawa Shigeru, Sawa Yoshiki
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
SAGE Open Med Case Rep. 2022 Mar 15;10:2050313X221085101. doi: 10.1177/2050313X221085101. eCollection 2022.
We report a case of a 28-year-old man with unrepaired congenitally corrected transposition of the great arteries, ventricular septal defect, and pulmonary stenosis who presented with septic shock due to infective endocarditis by . The cardiac catheterization had the risk of vegetation scattering. Without invasive hemodynamic assessment, the degree of pulmonary stenosis and left ventricle preparation as a systemic ventricle could not be accurately determined, making surgical planning difficult. We chose a staged approach with pulmonary valve replacement first for source control, followed by a more definitive operation following recovery from endocarditis.
我们报告了一例28岁男性患者,患有未经修复的先天性矫正型大动脉转位、室间隔缺损和肺动脉狭窄,因感染性心内膜炎导致感染性休克。心导管检查存在赘生物播散的风险。在没有有创血流动力学评估的情况下,无法准确确定肺动脉狭窄的程度以及作为体循环心室的左心室的准备情况,这使得手术规划变得困难。我们选择了一种分期方法,首先进行肺动脉瓣置换以控制感染源,然后在感染性心内膜炎恢复后进行更确定性的手术。