Schuenemann S, Andreas S, Kreuzer H, Werner G S
Department of Cardiology, Georg-August-University Goettingen, Fed. Rep. Germany.
J Am Soc Echocardiogr. 1998 Jan;11(1):77-9. doi: 10.1016/s0894-7317(98)70125-7.
Prosthetic valve endocarditis is a serious complication after valve replacement with an incidence of 0.8% for both mechanical and bioprosthetic valves. The new Toronto stentless porcine valve (SPV) for aortic replacement offers promising early results in hemodynamics and a low incidence of valve-related complications. The yearly incidence of bacterial endocarditis was reported to be 1% to 1.5%. Though complications such as a perivalvular abscess or anular dehiscence require immediate surgery, a conservative management of infective endocarditis may be possible in carefully selected cases. This is the case of a patient with late prosthetic valve endocarditis of a Toronto SPV bioprosthesis, who, in spite of large vegetations on all three valve cusps, responded well to conservative treatment. This response was monitored through repeated transesophageal echocardiographic studies (TEE), which documented complete functional recovery of the valve.
人工瓣膜心内膜炎是瓣膜置换术后的一种严重并发症，机械瓣膜和生物瓣膜的发生率均为0.8%。用于主动脉置换的新型多伦多无支架猪瓣膜（SPV）在血流动力学方面取得了令人鼓舞的早期结果，且瓣膜相关并发症的发生率较低。据报道，细菌性心内膜炎的年发病率为1%至1.5%。尽管诸如瓣周脓肿或瓣环裂开等并发症需要立即手术，但在经过精心挑选的病例中，对感染性心内膜炎进行保守治疗或许是可行的。本文报道的这例患者为多伦多SPV生物瓣膜晚期人工瓣膜心内膜炎，尽管三个瓣膜尖上均有大量赘生物，但对保守治疗反应良好。通过重复经食管超声心动图检查（TEE）监测这一反应，该检查记录了瓣膜的完全功能恢复情况。
