Sasaki Hideki, Numata Yukihide, Saito Jien, Kamiya Shinji, Asano Miki
Cardiovascular Surgery, Nagoya City University East Medical Center, Nagoya, JPN.
Cureus. 2023 Mar 17;15(3):e36315. doi: 10.7759/cureus.36315. eCollection 2023 Mar.
A 68-year-old male presented with a two-week history of fever, and further investigations revealed mitral valve endocarditis caused by , with associated severe mitral regurgitation (MR). The patient was referred for mitral valve surgery but developed new neurological symptoms two days before the operation, which were diagnosed as symptomatic epilepsy. During surgery, kissing lesions were found on the posterior mitral leaflet (PML), which were not detected on preoperative transesophageal echocardiography (TEE). Mitral valve repair was completed using autologous pericardium. The current case highlights the importance of careful examination of leaflets during surgery and not relying solely on preoperative imaging to detect all lesions. It is essential to promptly diagnose and treat infective endocarditis to prevent further complications and ensure successful outcomes.
一名68岁男性，有两周发热病史，进一步检查发现由……引起的二尖瓣心内膜炎，并伴有严重二尖瓣反流（MR）。该患者被转诊接受二尖瓣手术，但在手术前两天出现了新的神经症状，被诊断为症状性癫痫。手术中，在二尖瓣后叶（PML）发现了“亲吻病变”，术前经食管超声心动图（TEE）未检测到。使用自体心包完成了二尖瓣修复。本病例强调了手术中仔细检查瓣膜叶的重要性，而不能仅仅依赖术前影像学检查来发现所有病变。及时诊断和治疗感染性心内膜炎对于预防进一步并发症和确保成功治疗结果至关重要。
