The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Catheter Cardiovasc Interv. 2023 Jul;102(1):155-158. doi: 10.1002/ccd.30694. Epub 2023 May 20.
A 70-year-old man with history of transcatheter aortic valve-in-valve implantation was admitted because of suspected infective endocarditis (IE). Transesophageal echocardiogram did not reveal any vegetations, as the metallic stent frames caused significant artifacts. Position emission tomography was also negative. Intracardiac echocardiogram (ICE) was performed retrogradely through the ascending aorta, which showed clear vegetations over the stent frame of the transcatheter heart valve. Endocarditis after transcatheter aortic valve implantation was not uncommon. With increasing use of valve-in-valve procedures, echocardiographic diagnosis of IE would be more challenging. This case demonstrated the advantage of ICE over conventional echocardiography in visualizing the neo-aortic valve complex for diagnosing IE.
一位 70 岁男性，有经导管主动脉瓣瓣中瓣植入术史，因疑似感染性心内膜炎（IE）入院。经食管超声心动图未发现任何赘生物，因为金属支架框架造成了严重的伪影。正电子发射断层扫描也是阴性的。经逆行升主动脉进行心腔内超声（ICE）检查，显示经导管心脏瓣膜的支架框架上有明显的赘生物。经导管主动脉瓣植入术后的心内膜炎并不少见。随着瓣中瓣手术的应用越来越多，IE 的超声心动图诊断将更具挑战性。本病例展示了 ICE 相对于传统超声心动图在可视化新主动脉瓣复合体以诊断 IE 方面的优势。
