Feigl D, Feigl A, Edwards J E
Chest. 1986 Oct;90(4):553-7. doi: 10.1378/chest.90.4.553.
Twenty specimens of heart with mycotic aneurysms at the aortic root were studied. In ten cases, mycotic aneurysm followed infection of the aortic valve. In one case, it developed following infection of an aortic jet lesion, and in nine patients, the aneurysm was at the seat of a prosthetic aortic valve. In seven of the 11 cases with a natural aortic valve, the valve was either unicuspid or bicuspid. A retrospective evaluation of the data on the clinical records of the 20 patients revealed that infective endocarditis or noncardiac postoperative sepsis was present in 11. The most frequently isolated microorganism was Staphylococcus aureus. Conduction disturbances were found in six patients, all of them with involvement of the atrioventricular node by the aneurysm. Perforation into intracardiac cavities was found in four, two into the right ventricular infundibulum and one each into each atrium. Pericardial tamponade was caused by bleeding from the aneurysm in two cases, and myocardial infarction was a probable consequence of coronary arterial compression by the aneurysm in two cases. Mycotic aneurysms of the aortic root, in spite of their being partially or completely healed of active infection, carry a high risk of the complications enumerated. Among the 20 cases, cultures were positive in 11 and negative in nine. Staphylococcus aureus was cultured from five of the cases.
对20例主动脉根部有霉菌性动脉瘤的心脏标本进行了研究。10例中，霉菌性动脉瘤继发于主动脉瓣感染。1例继发于主动脉喷射病变感染后发生，9例患者的动脉瘤位于人工主动脉瓣处。在11例天然主动脉瓣的病例中，7例瓣膜为单叶或双叶。对20例患者临床记录数据的回顾性评估显示，11例存在感染性心内膜炎或非心脏术后败血症。最常分离出的微生物是金黄色葡萄球菌。6例患者发现传导障碍，所有患者的动脉瘤均累及房室结。4例发现动脉瘤穿破至心腔内，2例穿破至右心室漏斗部，1例穿破至每个心房。2例因动脉瘤出血导致心包填塞，2例冠状动脉可能因动脉瘤受压而发生心肌梗死。主动脉根部霉菌性动脉瘤，尽管其活动性感染部分或完全愈合，但仍具有上述列举的高并发症风险。20例中，11例培养阳性，9例阴性。5例培养出金黄色葡萄球菌。
