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不幸的意外双胞胎：两名患有带瓣管道心内膜炎的患者

Unfortunate Accidental Twins: Two Patients with Endocarditis of a Valve-Bearing Conduit.

作者信息

Ostovar Roya, Albes Johannes M

机构信息

Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Faculty of Health Sciences, Bernau, Brandenburg, Germany.

出版信息

Thorac Cardiovasc Surg Rep. 2023 Jul 10;12(1):e44-e47. doi: 10.1055/s-0043-1770722. eCollection 2023 Jan.

DOI:10.1055/s-0043-1770722
PMID:37434778
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10332900/
Abstract

Prosthetic valve endocarditis is becoming more common because many patients live long enough to experience bacteremia, while insufficient antibiotic prophylaxis eventually leads to graft infection. Valve-bearing conduit infections are the most feared because of technical challenges.  Two young patients were coincidental twins in terms of diagnosis and therapy. Both underwent complete replacement of the conduit, aortic arch prosthesis, and additional strategies to reconnect the coronary ostia and the brachiocephalic trunk. Both were discharged without significant residual problems.  Even most demanding infectious problems can be solved. Thus, surgery should not be denied.

摘要

人工瓣膜心内膜炎正变得越来越常见，因为许多患者存活时间足够长，会经历菌血症，而抗生素预防不足最终会导致移植物感染。由于技术难题，带瓣膜管道感染是最令人担忧的。 两名年轻患者在诊断和治疗方面是同卵双胞胎。两人都接受了管道、主动脉弓假体的完全置换，以及重新连接冠状动脉口和头臂干的额外策略。两人出院时均无明显残留问题。 即使是最棘手的感染问题也能得到解决。因此，不应拒绝手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa0d/10332900/e605f04ea81b/10-1055-s-0043-1770722-i0120230462crc-4.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa0d/10332900/5188af61ca5c/10-1055-s-0043-1770722-i0120230462crc-1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa0d/10332900/e605f04ea81b/10-1055-s-0043-1770722-i0120230462crc-4.jpg

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本文引用的文献

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Thorac Cardiovasc Surg. 2023 Jan;71(1):12-21. doi: 10.1055/s-0042-1748950. Epub 2022 Jul 4.
3
Endocarditis: An Ever Increasing Problem in Cardiac Surgery.
心内膜炎：心脏外科领域日益严峻的问题
Thorac Cardiovasc Surg. 2019 Dec;67(8):616-623. doi: 10.1055/s-0039-1688475. Epub 2019 May 1.
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Circulation. 2016 Nov 15;134(20):e412-e460. doi: 10.1161/CIR.0000000000000457. Epub 2016 Oct 13.
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Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.成人感染性心内膜炎：诊断、抗菌治疗和并发症处理：美国心脏协会医疗保健专业人员科学声明。
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Management of prosthetic graft infection after surgery of the thoracic aorta: removal of the prosthetic graft is not necessary.胸主动脉手术后人工血管感染的管理：无需移除人工血管。
J Thorac Cardiovasc Surg. 2007 Oct;134(4):1051-2. doi: 10.1016/j.jtcvs.2007.02.055.
7
A long-term experience with the Cabrol root replacement technique for the management of ascending aortic aneurysms and dissections.采用卡布罗（Cabrol）根部置换技术治疗升主动脉瘤和夹层的长期经验。
Ann Thorac Surg. 2003 Jan;75(1):126-31. doi: 10.1016/s0003-4975(02)04284-4.