Kingston Health Science Centre, Kingston, Ontario, Canada.
Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
Ann R Coll Surg Engl. 2022 Jul;104(7):e216-e218. doi: 10.1308/rcsann.2021.0334. Epub 2022 Apr 21.
We present an unusual case of occult mechanical aortic valve endocarditis caused by (), which occurred five years after the initial cardiac surgical procedure. The only potential source of this infection from the patient's past medical history was a gastric band removal followed by a gastric bypass surgery, which was performed two years prior to her redo cardiac procedure. The patient's main presenting symptom was progressive dyspnoea with worsening of gradients across the mechanical aortic valve. Of note, she had no cardinal symptoms of infection. The patient underwent redo bioprosthetic aortic valve replacement with aortic root replacement. Prosthetic valve cultures grew while blood cultures remained negative. She was started on intravenous antibiotics for six weeks and her postoperative course was uneventful. She remained symptom-free six months postoperatively. This case opens the discussion for the importance of administering antibiotics prophylaxis for endocarditis in patients with prosthetic heart valves undergoing gastric procedures.
我们报告了一例由 （）引起的隐匿性机械性主动脉瓣心内膜炎的罕见病例，该病例发生在初始心脏手术后五年。从患者过去的病史来看，这种感染的唯一潜在来源是胃带去除术，随后进行了胃旁路手术，这是在她再次进行心脏手术前两年进行的。患者的主要表现症状是进行性呼吸困难，机械性主动脉瓣跨瓣压差逐渐增大。值得注意的是，她没有感染的典型症状。患者接受了再次生物瓣主动脉瓣置换术和主动脉根部置换术。假体瓣膜培养物中生长出 ，而血培养仍为阴性。她接受了六周的静脉抗生素治疗，术后过程顺利。术后六个月，她仍无症状。该病例引发了关于对接受心脏假体的患者在进行胃手术时预防性使用抗生素以预防心内膜炎的重要性的讨论。
