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带瓣同种异体移植植入物治疗永存左上腔静脉患者合并瓣周脓肿的人造心脏主动脉心内膜炎。

Homograft implant for prosthetic aortic endocarditis with paravalvular abscess in a patient with persistent left superior vena cava.

机构信息

Department of Cardiothoracic and Vascular Disease, Division of Cardiac Surgery, Santa Maria alle Scotte Hospital, University of Siena, Siena, Italy.

Department of Cardiothoracic Surgery, Cardiovascular Research Institute-Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.

出版信息

Multimed Man Cardiothorac Surg. 2024 Oct 15;2024. doi: 10.1510/mmcts.2024.042.

Abstract

We present a case report detailing the surgical intervention in a patient with prosthetic aortic valve endocarditis complicated by a paravalvular abscess extending to the mitral-aortic fibrosa. Urgent surgery was required due to severe detachment of the prosthetic aortic valve, marking her third cardiac surgical procedure. Notably, preoperative imaging revealed the presence of a persistent left superior vena cava, a rare vascular anomaly requiring specialized cannulation techniques. The surgical approach involved removal of the infected tissue and prosthetic valve, followed by replacement with a cryopreserved aortic homograft, chosen for its anatomical adaptability.

摘要

我们报告了 1 例病例,详细介绍了 1 例因瓣周脓肿延伸至二尖瓣-主动脉纤维隔而合并人工主动脉瓣心内膜炎的患者的手术干预措施。由于人工主动脉瓣严重分离,这是该患者第三次心脏手术,因此需要紧急手术。值得注意的是,术前影像学检查显示永存左上腔静脉,这是一种罕见的血管异常,需要特殊的插管技术。手术方法包括切除感染组织和人工瓣膜,然后用冷冻保存的同种主动脉移植物置换,选择这种移植物是因为其解剖适应性。

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