Yin Qin, An Qi
Department of Anesthesiology, West China Hospital, Sichuan University/West China School of Nursing, Chengdu, Sichuan, China.
Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Medicine (Baltimore). 2025 Aug 8;104(32):e43910. doi: 10.1097/MD.0000000000043910.
Pulmonary pseudoaneurysm resulting from infective endocarditis is a rare complication in patients with congenital heart disease who have undergone conduit placement.
In this article, we report a rare case of late-onset bacterial infective endocarditis complicated by a pseudoaneurysm and severe pulmonary valve regurgitation in a 16-year-old girl with double-outlet right ventricle, ventricular septal defect, and pulmonary stenosis, who had previously undergone a Rastelli procedure at age 15.
Based on the patient's medical history and transthoracic echocardiography examinations and cardiac computed tomography angiography, a definitive diagnosis of late-onset bacterial infective endocarditis complicated by a pseudoaneurysm and severe pulmonary valve regurgitation was established.
Given the patient's worsening clinical condition, surgery for ventricular septal defect closure, placement of a new right-ventricle-to-pulmonary-artery conduit with a Gore-tex conduit was conducted.
The surgical procedure was successful. The patient was extubated 3 hours postoperatively and received 6 weeks of antibiotic therapy postoperatively, during which no further episodes of fever occurred, and the inflammatory markers decreased to normal levels.
For bacterial infective endocarditis associated with pulmonary pseudoaneurysm and severe pulmonary valve regurgitation, early surgical intervention is essential to mitigate further cardiac dysfunction and improve clinical outcomes.
感染性心内膜炎导致的肺假性动脉瘤是接受管道置入的先天性心脏病患者中罕见的并发症。
在本文中，我们报告了一例罕见病例，一名16岁患有右心室双出口、室间隔缺损和肺动脉狭窄的女孩，曾在15岁时接受过Rastelli手术，发生了迟发性细菌性感染性心内膜炎，并发假性动脉瘤和严重肺动脉瓣反流。
根据患者的病史、经胸超声心动图检查和心脏计算机断层血管造影，确诊为迟发性细菌性感染性心内膜炎，并发假性动脉瘤和严重肺动脉瓣反流。
鉴于患者临床状况恶化，进行了室间隔缺损闭合手术，并使用Gore-tex管道置入了一条新的右心室至肺动脉管道。
手术成功。患者术后3小时拔管，术后接受了6周的抗生素治疗，在此期间未再出现发热，炎症指标降至正常水平。
对于与肺假性动脉瘤和严重肺动脉瓣反流相关的细菌性感染性心内膜炎，早期手术干预对于减轻进一步的心脏功能障碍和改善临床结果至关重要。
