| Surgical Treatment for Active
Infective Endocarditis with Sinus of Valsalva and Right Atrium
Fistula |
(Department of Cardiovascular Surgery, Matsudo City
Hospital, Chiba, Japan)
| Makoto Takiguchi |
Hiroshi Watanabe |
Masao Shibairi |
| Kazuro Utsumi |
Yuzo Nagase |
Hideo Ukita |
|
We report here a surgical case of
sinus of Valsalva and right atrium fistula associated with acute
infective endocarditis (AIE) without perivalvular abscess cavity
or aneurysm of the sinus of Valsalva (ASV). A 51-year-old man,
who had been given a diagnosis of rheumatic aortic stenosis and
regurgitation (AsR) and mitral stenosis and regurgitation (MsR)
and tricuspid regurgitation (TR) by echocardiography, had a high
fever 2 months after removal of teeth and AIE was diagnosed.
He was referred to our hospital because sinus of Valsalva and
right atrium fistula were detected by echocardiography and congestive
heart failure (CHF) deteriorated during medical treatment. Perivalvular
abscess cavity and ASV were not detected by preoperative echocardiography.
Medical treatment was continued after admission, and operation
was done after amelioration of the CHF and infection were recognized.
The aortic valve was removed together with vegetation, two areas
of the aortic wall in which the tissue was fragile were cauterized
by electrocautery, patch closure at the sinus of Valsalva was
performed using a partial of e-PTFE graft and aortic valve replacement
(AVR) and mitral valve replacement (MVR) were done. Though residual
aortic-right atrium shunt was detected after the operation, the
postoperative course was good with no CHF or signs of infection.
Jpn. J. Cardiovasc. Surg. 30: 149-151 (2001) |
|
