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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.

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/10667874/507ffc6b965b/gr1.jpg

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