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急性重度主动脉瓣反流合并后天性Gerbode缺损的成功手术经验：一例报告

Successful surgical experience for acute severe aortic valve regurgitation with acquired Gerbode defect: A case report.

作者信息

Shirakawa Makoto, Fujii Masahiro, Onoda Sho, Yamashita Hiromasa, Kawase Yasuhiro, Bessho Ryuzo

机构信息

Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, Japan; Cardiovascular Surgery, Hanyu General Hospital, 446 Shimoiwase, Hanyu-city, Saitama 348-8505, Japan.

Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, Japan.

出版信息

Int J Surg Case Rep. 2023 Nov;112:108988. doi: 10.1016/j.ijscr.2023.108988. Epub 2023 Oct 26.

DOI:10.1016/j.ijscr.2023.108988
PMID:37898007
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10667874/
Abstract

INTRODUCTION AND IMPORTANCE

The incidence of acquired Gerbode defect has been increasing due to advances in cardiac imaging technology, and some closure methods have been introduced.

PRESENTATION OF CASE

A 58-year-old man developed cardiogenic shock due to acute severe aortic valve regurgitation with an acquired Gerbode defect caused by infective endocarditis. Emergency surgery was performed. A large patch with a 0.4 mm extended-polytetrafluoroethylene (e-PTFE) sheet covered with autologous pericardium was used to close the Gerbode defect, and a bioprosthetic valve was used for aortic valve replacement.

CLINICAL DISCUSSION

Large patch closure with 0.4 mm e-PTFE sheet and autologous pericardium for fragile Gerbode defect caused by infective endocarditis might be effective with regard to sturdiness, good fitting to the tissue, and excellent resistance to bacteria.

CONCLUSION

We encountered a rare case of cardiogenic shock due to acute severe aortic valve regurgitation and acquired Gerbode defect caused by infective endocarditis. In our case, large-patch closure for perforation in a fragile membranous septum was effective.

摘要

引言与重要性

由于心脏成像技术的进步，后天性Gerbode缺损的发病率一直在上升，并且已经引入了一些闭合方法。

病例介绍

一名58岁男性因急性严重主动脉瓣反流并伴有感染性心内膜炎导致的后天性Gerbode缺损而发生心源性休克。进行了急诊手术。使用一块覆盖有自体心包的0.4毫米扩展聚四氟乙烯（e-PTFE）片的大补片来闭合Gerbode缺损，并使用生物人工瓣膜进行主动脉瓣置换。

临床讨论

对于感染性心内膜炎导致的脆弱的Gerbode缺损，使用0.4毫米e-PTFE片和自体心包进行大补片闭合在坚固性、与组织的良好贴合度以及出色的抗菌性方面可能是有效的。

结论

我们遇到了一例罕见的因急性严重主动脉瓣反流和感染性心内膜炎导致的后天性Gerbode缺损而引起的心源性休克病例。在我们的病例中，对脆弱的膜性间隔穿孔进行大补片闭合是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bfc/10667874/74774a572f71/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bfc/10667874/507ffc6b965b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bfc/10667874/74774a572f71/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bfc/10667874/507ffc6b965b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bfc/10667874/74774a572f71/gr2.jpg

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本文引用的文献

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Active infective endocarditis of a bicuspid aortic valve causing left ventricular outflow tract pseudoaneurysm and right atrium shunt: A case report.二叶式主动脉瓣活动性感染性心内膜炎致左心室流出道假性动脉瘤及右心房分流：一例报告
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The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines.SCARE 2020 指南：更新共识手术病例报告（SCARE）指南。
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使用Amplatzer血管封堵器II经皮闭合获得性和医源性左心室-右心房交通（Gerbode缺损）
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Gerbode defect: Another nail for the 3D transesophagel echo hammer?Gerbode缺损：3D经食管超声心动图这把锤子又钉上一颗钉子？
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