University Clinical Center of Surgery, Department of Cardiac Surgery, Auenbruggerplatz 2934/3, 8036 Graz, Austria.
Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 5/5, A-8036 Graz, Austria.
Multimed Man Cardiothorac Surg. 2024 Aug 14;2024. doi: 10.1510/mmcts.2024.052.
Infective endocarditis, particularly after implanting valve prostheses, poses significant surgical challenges, often requiring complex interventions. We describe a case of a 37-year-old male with Staphylococcus aureus endocarditis, unsuccessfully treated with mechanical valve prostheses. Continued infection led to the destruction of the intervalvular fibrous body, necessitating a Commando procedure involving radical debridement and replacement of both aortic and mitral valves with complex patch reconstruction. Prosthesis selection remains contentious, considering recurrence risk and long-term prognosis. Our case underscores timely intervention and meticulous technique in managing such complex situations. It highlights successful strategies for treating infective endocarditis with destruction of aortomitral continuity, emphasizing the pivotal role of the Commando procedure.
感染性心内膜炎，尤其是在植入瓣膜假体后，会带来重大的手术挑战，往往需要复杂的干预措施。我们描述了一位 37 岁男性患有金黄色葡萄球菌心内膜炎的病例，该患者在使用机械瓣膜假体治疗后效果不佳。持续的感染导致瓣间隔纤维体破坏，需要进行 Commando 手术，包括彻底清创以及用复杂的补片重建来替换主动脉瓣和二尖瓣。考虑到复发风险和长期预后，假体的选择仍然存在争议。我们的病例强调了在处理此类复杂情况时及时干预和细致技术的重要性。它突出了成功的策略，用于治疗伴有主-二尖瓣连续性破坏的感染性心内膜炎，强调了 Commando 手术的关键作用。
