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经导管主动脉瓣植入术后感染性心内膜炎合并脓毒性栓塞性中风:一例报告

Infective Endocarditis Complicated With Septic Embolic Stroke After Transcatheter Aortic Valve Implantation: A Case Report.

作者信息

Arayakarnkul Suchapa, Lorlowhakarn Koravich, Puwanant Sarinya, Srimahachota Suphot, Ariyachaipanich Aekarach

机构信息

Internal Medicine, Chulalongkorn University, Bangkok, THA.

Cardiovascular Medicine, Chulalongkorn University, Bangkok, THA.

出版信息

Cureus. 2022 May 26;14(5):e25379. doi: 10.7759/cureus.25379. eCollection 2022 May.

Abstract

Transcatheter aortic valve implantation (TAVI) is a relatively novel procedure developed for aortic stenosis (AS) management in patients with moderate to high surgical risk, especially the elderly with multiple comorbidities. Infective endocarditis following transcatheter aortic valve implantation (post-TAVI-IE) is an uncommon complication that contributes to very high morbidity and mortality. Further complications from post-TAVI-IE include ischemic stroke from septic emboli. Here, we report a case of an 82-year-old man with severe symptomatic AS who underwent TAVI, presenting with fever and alteration of consciousness, which was diagnosed as post-TAVI-IE per Duke criteria complicated by acute hemiparesis from septic emboli stroke. He was treated successfully conservatively using antibiotics. We have reviewed the options of treatment and outcomes for post-TAVI-IE.

摘要

经导管主动脉瓣植入术(TAVI)是一种相对较新的手术方法,用于治疗手术风险中至高度的主动脉瓣狭窄(AS)患者,尤其是患有多种合并症的老年人。经导管主动脉瓣植入术后感染性心内膜炎(TAVI术后IE)是一种罕见的并发症,会导致非常高的发病率和死亡率。TAVI术后IE的进一步并发症包括感染性栓子引起的缺血性中风。在此,我们报告一例82岁有严重症状性AS的男性患者,他接受了TAVI手术,术后出现发热和意识改变,根据杜克标准诊断为TAVI术后IE,并伴有感染性栓子性中风导致的急性偏瘫。他通过使用抗生素成功接受了保守治疗。我们回顾了TAVI术后IE的治疗选择和结果。

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