Cherkasy Regional Cardiology Center, Cherkasy, Ukraine. This is a municipal non-profit enterprise.
М.M. Amosov National Institute of Cardio-vascular Surgery, Kyiv, Ukraine.
Multimed Man Cardiothorac Surg. 2023 Nov 6;2023. doi: 10.1510/mmcts.2023.073.
We present a case of a Staphylococcus epidermidis early prosthetic valve endocarditis after minimally invasive sutureless aortic valve replacement. The patient developed a root abscess with a fistula, severe mitral and periprosthetic regurgitations, with a large mitral vegetation and a residual patent foramen ovale. The surgical approach consisted of a redo median sternotomy, explantation of a sutureless aortic prosthesis, resection of an intervalvular fibrosa and anterior mitral leaflet and debridement of an aortic root-left ventricle outflow tract abscess. These procedures were followed by a root-commando procedure with mitral and aortic root placement using a self-assembled mechanical aortic root conduit. The technique used is an alternative to a root-commando procedure performed with an allograft or a Medtronic Freestyle bioprosthesis. The same technique can be utilized with a commercially available stented bioprosthesis.
我们报告 1 例微创无缝线主动脉瓣置换术后早期表皮葡萄球菌性人工瓣膜心内膜炎病例。该患者发生了根部脓肿伴瘘管、严重二尖瓣和瓣周反流，伴大的二尖瓣赘生物和残余卵圆孔未闭。手术入路包括再次正中胸骨切开术、无缝线主动脉瓣假体取出、间隔纤维切除和前二尖瓣叶切除以及主动脉根部-左心室流出道脓肿清创术。随后采用自组装机械主动脉根部导管进行根部-指挥术，行二尖瓣和主动脉根部置换。该技术可替代同种异体移植物或美敦力 Freestyle 生物瓣行根部-指挥术。该技术也可用于商业上可获得的带支架的生物瓣。
