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室间隔缺损封堵术后晚期心内膜炎：一例报告

Late endocarditis after device closure of ventricular septal defect: a case report.

作者信息

Nazrin Tahera, Reza Sadeed Araf, Naher Nurun, Nahid Farzana, Reza A Q M

机构信息

Department of Cardiology and Pediatric Cardiology, Evercare Hospital Dhaka, Plot 81, Block-E, Bashundhara R/A, Dhaka 1229, Bangladesh.

Sir Salimullah Medical College Mitford Hospital, Mitford Road, Dhaka-1100, Bangladesh.

出版信息

Eur Heart J Case Rep. 2025 Jun 20;9(7):ytaf288. doi: 10.1093/ehjcr/ytaf288. eCollection 2025 Jul.

DOI:10.1093/ehjcr/ytaf288
PMID:40606017
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12210232/
Abstract

BACKGROUND

Among all congenital heart diseases, ventricular septal defect (VSD) is the most common. Transcatheter device closure of VSD is an increasingly practiced intervention in recent times because patients can avoid the burden of surgery and associated morbidity. Infective endocarditis (IE) associated with this intervention is a very rare occurrence. Patients are considered to be at high risk of developing IE in the initial 6 months after septal defect closure device implantation.

CASE SUMMARY

We report a case of late IE in a 7 years old female. She had a transcatheter device closure of a perimembranous VSD at the age of 3, using a Konar MFO device. The patient presented with altered consciousness, convulsions, moderate fever and tachycardia. MRI of brain revealed basilar and posterior inferior cerebellar artery thrombosis leading to central pontine and right cerebellar infarct. Transoesophageal echocardiography displayed mobile thread like vegetation attached to the left knob of the MFO device just below the aortic valve. Blood culture revealed growth. A diagnosis of IE was reached.

DISCUSSION

Transcatheter device closure of VSD has been shown to be safe and effective in various studies. IE associated with this intervention is extremely rare with just a handful of cases reported. As far as we are aware, this is the first reported case of IE associated with VSD device due to

摘要

背景

在所有先天性心脏病中，室间隔缺损（VSD）最为常见。近年来，经导管封堵室间隔缺损的介入治疗越来越普遍，因为患者可以避免手术负担及相关并发症。与该介入治疗相关的感染性心内膜炎（IE）极为罕见。在间隔缺损封堵装置植入后的最初6个月内，患者被认为发生IE的风险较高。

病例摘要

我们报告一例7岁女性发生的迟发性IE。她在3岁时使用Konar MFO装置经导管封堵膜周部室间隔缺损。患者出现意识改变、惊厥、中度发热和心动过速。脑部MRI显示基底动脉和小脑后下动脉血栓形成，导致桥脑中央和右侧小脑梗死。经食管超声心动图显示在主动脉瓣下方，MFO装置的左旋钮上附着有活动的丝状赘生物。血培养有细菌生长。确诊为IE。

讨论

多项研究表明，经导管封堵室间隔缺损安全有效。与该介入治疗相关的IE极为罕见，仅有少数病例报道。据我们所知，这是首例因……导致的与室间隔缺损装置相关的IE报道病例

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/e54edfb6c6e9/ytaf288f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/94db05e66594/ytaf288f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/6bee17f1b4db/ytaf288f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/36c2ee788fad/ytaf288f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/2ce5e0b26825/ytaf288f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/e54edfb6c6e9/ytaf288f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/94db05e66594/ytaf288f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/6bee17f1b4db/ytaf288f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/36c2ee788fad/ytaf288f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/2ce5e0b26825/ytaf288f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f442/12210232/e54edfb6c6e9/ytaf288f5.jpg

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Experiences of Two Centers in Percutaneous Ventricular Septal Defect Closure Using Konar Multifunctional Occluder.经 Konar 多功能封堵器行经皮室间隔缺损封堵的两中心经验。
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The first described case of late infective endocarditis after implantation of Figulla Flex Ⅱ ASD occluder.首例关于植入Figulla FlexⅡ型房间隔缺损封堵器后发生晚期感染性心内膜炎的病例报道。
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