Wu Shaofeng, Wang Xin, Ren Weidong, Song Guang, Hou Yang, Hu Haidi, Yu Xiaona
Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Radiation, Shengjing Hospital of China Medical University, Shenyang, China.
Front Cardiovasc Med. 2023 Jan 9;9:1020186. doi: 10.3389/fcvm.2022.1020186. eCollection 2022.
Prosthetic valve endocarditis (PVE) is a rare but dangerous complication of Bentall surgery and PVE involving multiple valves simultaneously during the early postoperative period has not been reported. A 42 year old patient admitted to intensive care unit with fever 1 month after aortic valve replacement (Bentall procedure). Echocardiography was of great diagnosis value and suggested large, mobile vegetations on both the prosthetic aortic valve and native tricuspid valve. The presence of was revealed by multiple blood cultures. Surgery was not performed because of the history of aortic valve replacement 1 month ago. He developed acute right femoral artery thromboembolism, multiple cerebral infarction and splenic infarction during hospitalization and died of cerebral infarction after being discharged. This case underlines that patients with early PVE may have poor prognosis and fatal systemic embolism should be aware of in PVE patients with large vegetations present with dyskinesia, abdominal pain, and limb numbness. The timely echocardiography and vascular ultrasound are primary and reliable diagnostic methods in this scenario.
人工瓣膜心内膜炎（PVE）是Bentall手术罕见但危险的并发症，术后早期同时累及多个瓣膜的PVE尚未见报道。一名42岁患者在主动脉瓣置换术（Bentall手术）后1个月因发热入住重症监护病房。超声心动图具有重要诊断价值，提示人工主动脉瓣和天然三尖瓣上均有大的活动赘生物。多次血培养发现了病原体。由于1个月前有主动脉瓣置换史，未进行手术。他在住院期间发生急性右股动脉血栓栓塞、多发性脑梗死和脾梗死，出院后死于脑梗死。该病例强调，早期PVE患者预后可能较差，对于存在大赘生物、有运动障碍、腹痛和肢体麻木的PVE患者，应警惕致命的全身栓塞。在这种情况下，及时的超声心动图和血管超声是主要且可靠的诊断方法。
