Carlson Andrew, Zayyad Zaid, Abdul-Kafi Owais, Mishra Satish, Amoateng Richard, Vamenta Stefanie, Briller Joan, Ibrahim Khalil
University of Illinois, Chicago, Illinois, USA.
JACC Case Rep. 2024 Nov 6;29(21):102698. doi: 10.1016/j.jaccas.2024.102698.
Infective endocarditis is rare but carries significant morbidity, including risk of systemic embolization. A 67-year-old woman presented with endocarditis. Evaluation revealed a mobile mitral valve vegetation and a right atrial mass. Owing to prohibitive surgical risk, percutaneous aspiration thrombectomy was pursued. Immediate preprocedural transesophageal echocardiography revealed that the mitral mass had embolized in the interval, and it was incidentally found in the common left femoral artery on ultrasound. The patient underwent aspiration thrombectomy of the right atrial mass and open surgical extraction of the mitral valve vegetation from the femoral artery in the same index procedure. This case highlights the high embolization potential of these types of valvular vegetations and the need for rapid intervention.
感染性心内膜炎虽罕见，但具有较高的发病率，包括全身栓塞风险。一名67岁女性因心内膜炎就诊。评估发现二尖瓣有活动赘生物及右心房肿块。鉴于手术风险过高，遂行经皮抽吸血栓切除术。术前即刻经食管超声心动图显示二尖瓣肿块在检查期间已发生栓塞，超声检查偶然发现其位于左股总动脉。在同一次手术中，患者接受了右心房肿块抽吸血栓切除术及从股动脉开放手术摘除二尖瓣赘生物。该病例凸显了这类瓣膜赘生物的高栓塞风险以及快速干预的必要性。
