Department of Cardiology, University of Health Sciences Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey.
Department of Cardiology, Zile State Hospital, Tokat, Turkey.
Turk Kardiyol Dern Ars. 2022 Oct;50(7):527-530. doi: 10.5543/tkda.2022.21318.
A 61-year-old male presented to emergency department with symptoms of shortness of breath, palpitations, and night sweats. We performed bedside transthoracic echocardiography which showed shunt from the left ventricle to the right atrium in systole with color Doppler examination. Gerbode-type ventricular septal defect and an image of a fibrillar, mobile mass compatible with vegetation was observed just above the tricuspid valve. We performed transesophageal echocardiography which showed vegetations on the aortic valve noncoronary cusp. Two sets of blood cultures were positive for Streptococcus sanguinis. The patient was evaluated by the heart team and an operation decision was made for the patient. The patient underwent surgery after 2 weeks of antibiotic theraphy. In the surgery, the Gerbode-type ventricular septal defect was closed with a polytetrafluoroethylene patch. Tricuspid annuloplasty was performed with De Vega technique. Mechanical aortic valve was implanted. Postoperative transthoracic echocardiography showed no residual shunt.
一位 61 岁男性因呼吸急促、心悸和盗汗到急诊就诊。我们进行了床边经胸超声心动图检查，显示收缩期从左心室到右心房的分流，并进行了彩色多普勒检查。观察到室间隔隔瓣下型室间隔缺损和一个纤维状、可移动的团块，与赘生物一致，正好位于三尖瓣上方。我们进行了经食管超声心动图检查，显示主动脉瓣无冠状动脉瓣上的赘生物。两套血培养均为链球菌阳性。心脏团队对患者进行了评估，并为患者做出了手术决策。患者在抗生素治疗 2 周后接受了手术。手术中，使用聚四氟乙烯补片关闭室间隔隔瓣下型室间隔缺损。采用 De Vega 技术进行三尖瓣环成形术。植入机械主动脉瓣。术后经胸超声心动图显示无残余分流。
