Harada M, Hirai H, Inoue T, Sakai H, Lee T, Sugiyama Y, Suzuki M, Kamezaki M, Tamura S, Shiroma K, Ebine K, Takahashi K, Naoe S, Yamaguchi T
Third Department of Internal Medicine, Toho University School of Medicine, Tokyo.
J Cardiol. 1998;31 Suppl 1:105-13; discussion 114.
A rare case of aortic and mitral valve aneurysms complicated with infective endocarditis was accurately diagnosed by transesophageal echocardiography. A 57-year-old man with severe aortic regurgitation due to infective endocarditis was admitted to our hospital. Transthoracic echocardiography showed an aortic valve aneurysm on the right coronary cusp and perforations on the other cusps. Transesophageal echocardiography demonstrated a small aneurysm on the anterior leaflet of the mitral valve which was not clearly visualized by transthoracic echocardiography. Color Doppler echocardiography revealed severe aortic regurgitation and mild mitral regurgitation without perforation of the mitral valve aneurysm. Aortic valve replacement and mitral valvuloplasty of the anterior mitral leaflet were performed. The right coronary cusp of the aortic valve showed marked thinning with infiltration of inflammatory cells. The postoperative clinical course was uneventful.
一例罕见的主动脉瓣和二尖瓣动脉瘤合并感染性心内膜炎通过经食管超声心动图得以准确诊断。一名因感染性心内膜炎导致严重主动脉瓣反流的57岁男性入住我院。经胸超声心动图显示右冠状动脉瓣叶有主动脉瓣动脉瘤，其他瓣叶有穿孔。经食管超声心动图显示二尖瓣前叶有一个小动脉瘤，经胸超声心动图未清晰显示。彩色多普勒超声心动图显示严重主动脉瓣反流和轻度二尖瓣反流，二尖瓣动脉瘤无穿孔。进行了主动脉瓣置换术和二尖瓣前叶瓣膜成形术。主动脉瓣右冠状动脉瓣叶显示明显变薄，有炎性细胞浸润。术后临床过程平稳。
