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病例报告:主动脉瓣心内膜炎和复发性肺动脉瓣狭窄。

Case report: Aortic valve endocarditis and recurrent pulmonary valve stenosis.

机构信息

Department of Cardiac Surgery, Middle German Heart Centre, University Hospital Halle (Saale), Martin-Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.

出版信息

J Cardiothorac Surg. 2023 Mar 21;18(1):89. doi: 10.1186/s13019-023-02184-7.

DOI:10.1186/s13019-023-02184-7
PMID:36944991
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10029201/
Abstract

BACKGROUND

We discuss a rare case of an adult patient with different pathologies involving the aortic and pulmonary valves in need of surgery.

CASE PRESENTATION

The patient had a history of congenital PV stenosis and surgical valvuloplasty. Almost 50 years later the patient underwent a complex second heart surgery due to infective endocarditis of the aortic valve and high-grade restenosis of the pulmonary valve. Replacement of the aortic and pulmonary valve, as well as reconstruction of the RVOT and closure of a persistent foramen ovale, followed. Postoperative course was uneventful and the patient was discharged home a week after surgery.

CONCLUSION

Simultaneous surgery of pulmonary and aortic valves due to different pathologies is rare but can be performed successfully even in advanced age and can improve quality of life.

摘要

背景

我们讨论了一例罕见的成年患者,其主动脉瓣和肺动脉瓣存在不同的病变,需要手术治疗。

病例介绍

患者既往有先天性肺动脉瓣狭窄和外科瓣成形术病史。近 50 年后,患者因主动脉瓣感染性心内膜炎和肺动脉瓣高度再狭窄行复杂的二次心脏手术。随后进行了主动脉瓣和肺动脉瓣置换,以及右心室流出道重建和卵圆孔未闭关闭术。术后过程顺利,患者在手术后一周出院回家。

结论

由于不同的病变而同时进行肺动脉瓣和主动脉瓣手术较为罕见,但即使在高龄时也可以成功进行,并且可以提高生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda6/10029201/36eaadf64239/13019_2023_2184_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda6/10029201/36eaadf64239/13019_2023_2184_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cda6/10029201/36eaadf64239/13019_2023_2184_Fig1_HTML.jpg

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本文引用的文献

1
Human Genetic Susceptibility to Native Valve Endocarditis in Patients With Bacteremia: Genome-Wide Association Study.菌血症患者对自身瓣膜心内膜炎的人类遗传易感性:全基因组关联研究
Front Microbiol. 2018 Apr 4;9:640. doi: 10.3389/fmicb.2018.00640. eCollection 2018.
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Surgically treated pulmonary stenosis: over 50 years of follow-up.手术治疗的肺动脉狭窄:超过50年的随访
Cardiol Young. 2016 Jun;26(5):860-6. doi: 10.1017/S1047951115001158. Epub 2015 Jul 21.
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Genetic variants in genes of the inflammatory response in association with infective endocarditis.
与感染性心内膜炎相关的炎症反应基因中的遗传变异。
PLoS One. 2014 Oct 9;9(10):e110151. doi: 10.1371/journal.pone.0110151. eCollection 2014.
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Pulmonary stenosis: update on diagnosis and therapeutic options.肺动脉狭窄:诊断与治疗选择的最新进展
Heart. 2013 Mar;99(5):339-47. doi: 10.1136/heartjnl-2012-301964. Epub 2013 Jan 8.
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The 1st balloon valvuloplasty: an historical note.首例球囊瓣膜成形术:一则历史记录。
J Vet Intern Med. 2002 Jan-Feb;16(1):116-7. doi: 10.1892/0891-6640(2002)016<0116:tbvahn>2.3.co;2.
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Reoperation in adults with repair of tetralogy of fallot: indications and outcomes.成人法洛四联症修复术后再次手术:指征与结果
J Thorac Cardiovasc Surg. 1999 Aug;118(2):245-51. doi: 10.1016/S0022-5223(99)70214-X.