• 第二軍醫(yī)大學(xué)長(zhǎng)海醫(yī)院 胸心外科,上?!?00433;

目的 探討先天性心臟病合并肺動(dòng)脈瓣感染性心內(nèi)膜炎的外科治療方法和效果?!》椒ā?009年1月至2012年1月第二軍醫(yī)大學(xué)長(zhǎng)海醫(yī)院收治先天性心臟病合并肺動(dòng)脈瓣感染性心內(nèi)膜炎患者6例,男1例,女5例;年齡8~41 (24.8±11.8)歲。動(dòng)脈導(dǎo)管未閉(PDA)4例,PDA合并先天性主動(dòng)脈瓣狹窄1例,室間隔缺損(VSD)合并三尖瓣反流1例。3例行PDA結(jié)扎+肺動(dòng)脈內(nèi)贅生物清除術(shù),1例行PDA結(jié)扎+肺動(dòng)脈瓣贅生物切除術(shù),1例行PDA結(jié)扎+肺動(dòng)脈瓣贅生物切除術(shù)+主動(dòng)脈瓣置換術(shù)(AVR,置換19 mm CarboMetics環(huán)上機(jī)械主動(dòng)脈瓣),1例肺動(dòng)脈瓣膜破壞嚴(yán)重,行VSD修補(bǔ)+右心室流出道贅生物清除+右心室流出道拓寬+三尖瓣成形術(shù)+肺動(dòng)脈生物瓣置換術(shù)(置換27 mm HancockⅡ型生物瓣)?!〗Y(jié)果 6例患者術(shù)后均恢復(fù)良好,無(wú)圍術(shù)期死亡和心內(nèi)膜炎復(fù)發(fā)。所有患者復(fù)查超聲心動(dòng)圖提示,未見贅生物、殘余漏、瓣周漏等并發(fā)癥。術(shù)后隨訪6個(gè)月~3年中,患者臨床癥狀完全消失,均無(wú)明顯不適。術(shù)后心功能恢復(fù)至Ⅰ級(jí)5例,Ⅱ級(jí)1例?!〗Y(jié)論 對(duì)于先天性心臟病合并肺動(dòng)脈瓣感染性心內(nèi)膜炎患者,正確把握手術(shù)時(shí)機(jī),積極行外科手術(shù)治療是最有效的治療方法。

引用本文: 余詠潮,徐志云,徐激斌,唐昊,唐楊鋒. 先天性心臟病合并肺動(dòng)脈瓣感染性心內(nèi)膜炎的外科治療. 中國(guó)胸心血管外科臨床雜志, 2013, 20(1): 103-102. doi: 復(fù)制

版權(quán)信息: ?四川大學(xué)華西醫(yī)院華西期刊社《中國(guó)胸心血管外科臨床雜志》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1.  Ramadan FB, Beanlands DS, Burwash IG. Isolated pulmonic valve endocarditis in healthy hearts:a case report and review of the literature. Can J Cardiol, 2000, 16 (10):1282-1288.
2.  Vu M, Harrison BA, Destephano C, et al. Endocarditis, vegetation, and perforation of the pulmonary valve. J Cardiothorac Vasc Anesth, 2008, 22 (2):261-262.
3.  周建平, 周偉, 李偉陽(yáng). 靜脈藥癮所致感染性心內(nèi)膜炎的外科治療. 實(shí)用醫(yī)學(xué)雜志, 2008, 24 (5):796-797.
4.  Durack DT, Andrea SL, Bright DK, et al. New criteria for diagnosis of infective endocarditis:utilization of specific echocardiographic findings. Am J Med, 1994, 96 (3):200-209.
5.  Di Filippo S, Delahaye F, Semiond B, et al. Current patterns of infective endocarditis in congenital heart disease. Eur Heart J, 2006, 92 (10):1490-1495.
6.  Habib G, Badano L, Tribouilloy C, et al. Recommendations for the practice of echocardiography in infective endocarditis. Eur J Echocardiogr, 2010, 11 (2):202-219.
7.  李潭, 楊軍, 馬春燕, 等. 超聲評(píng)價(jià)先天性心臟病合并感染性心內(nèi)膜炎的價(jià)值. 中華臨床醫(yī)師雜志:電子版, 2012, 06 (5):1360-1361.
8.  Habib G, Hoen B, Tornos P, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009):The task force on the prevention, diagnosis, and treatment of Infective endoearditis of the European Society of Cardiology (ESC). Eur Heart J, 2009, 30 (19):2369-2413.
9.  Rohn V, Slais M, Kotulák T, et al. Pulmonary valve replacement for pacing electrodes related bacterial endocarditis. Ann Thorac Surg, 2008, 85 (6):2128-2130.
10.  劉寶玉, 姜建青, 周凱, 等. 感染性心內(nèi)膜炎的外科治療. 中國(guó)胸心血管外科臨床雜志, 2007, 14 (6):471-472.
11.  Musci M, Siniawski H, Pasic M, et al. Surgical treatment of right-sided active infective endocarditis with or without involvement of the left heart:20-year single center experience. Eur J Cardiothorac Surg, 2007, 32 (1):118-125.
  1. 1.  Ramadan FB, Beanlands DS, Burwash IG. Isolated pulmonic valve endocarditis in healthy hearts:a case report and review of the literature. Can J Cardiol, 2000, 16 (10):1282-1288.
  2. 2.  Vu M, Harrison BA, Destephano C, et al. Endocarditis, vegetation, and perforation of the pulmonary valve. J Cardiothorac Vasc Anesth, 2008, 22 (2):261-262.
  3. 3.  周建平, 周偉, 李偉陽(yáng). 靜脈藥癮所致感染性心內(nèi)膜炎的外科治療. 實(shí)用醫(yī)學(xué)雜志, 2008, 24 (5):796-797.
  4. 4.  Durack DT, Andrea SL, Bright DK, et al. New criteria for diagnosis of infective endocarditis:utilization of specific echocardiographic findings. Am J Med, 1994, 96 (3):200-209.
  5. 5.  Di Filippo S, Delahaye F, Semiond B, et al. Current patterns of infective endocarditis in congenital heart disease. Eur Heart J, 2006, 92 (10):1490-1495.
  6. 6.  Habib G, Badano L, Tribouilloy C, et al. Recommendations for the practice of echocardiography in infective endocarditis. Eur J Echocardiogr, 2010, 11 (2):202-219.
  7. 7.  李潭, 楊軍, 馬春燕, 等. 超聲評(píng)價(jià)先天性心臟病合并感染性心內(nèi)膜炎的價(jià)值. 中華臨床醫(yī)師雜志:電子版, 2012, 06 (5):1360-1361.
  8. 8.  Habib G, Hoen B, Tornos P, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009):The task force on the prevention, diagnosis, and treatment of Infective endoearditis of the European Society of Cardiology (ESC). Eur Heart J, 2009, 30 (19):2369-2413.
  9. 9.  Rohn V, Slais M, Kotulák T, et al. Pulmonary valve replacement for pacing electrodes related bacterial endocarditis. Ann Thorac Surg, 2008, 85 (6):2128-2130.
  10. 10.  劉寶玉, 姜建青, 周凱, 等. 感染性心內(nèi)膜炎的外科治療. 中國(guó)胸心血管外科臨床雜志, 2007, 14 (6):471-472.
  11. 11.  Musci M, Siniawski H, Pasic M, et al. Surgical treatment of right-sided active infective endocarditis with or without involvement of the left heart:20-year single center experience. Eur J Cardiothorac Surg, 2007, 32 (1):118-125.