Ichikawa Y, Soma T, Yamazaki I, Isoda S, Kondo J, Matsumoto A
Department of Cardiovascular Surgery, Saiseikai Yokohamashi-Nambu Hospital, Yokohama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Sep;42(9):1350-4.
A 59-year-old male was found to have two aneurysms in the mitral valve, mitral regurgitation, and aortic regurgitation by the echocardiographic examination. The patient had a previous history of infectious endocarditis by streptococcus at the age of 24. Under the diagnosis of mitral aneurysms developed after infectious endocarditis, surgery was undertaken. A 5 x 8 mm sized perforation in the right coronary cusp and two aneurysms in the anterior mitral leaflet, 22 mm and 17 mm in size, were found intraoperatively. Both the mitral and aortic valves were replaced. Patients with a history of infectious endocarditis have to be followed up for a long period of time. Transesophageal echocardiogram is useful in those patients. Considering high prevalence of aortic valvular diseases in those with a mitral aneurysm after infectious endocarditis, aortic valves should be carefully evaluated.
一名59岁男性经超声心动图检查发现二尖瓣有两个动脉瘤、二尖瓣反流和主动脉反流。该患者曾在24岁时患过链球菌感染性心内膜炎。在诊断为感染性心内膜炎后发生的二尖瓣动脉瘤后,进行了手术。术中发现右冠状动脉瓣叶有一个5×8毫米大小的穿孔,二尖瓣前叶有两个动脉瘤,大小分别为22毫米和17毫米。二尖瓣和主动脉瓣均被置换。有感染性心内膜炎病史的患者必须长期随访。经食管超声心动图对这些患者有用。考虑到感染性心内膜炎后二尖瓣动脉瘤患者中主动脉瓣疾病的高患病率,应仔细评估主动脉瓣。