| A Recurrent Case of Infectious
Endocarditis after Mitral Valve Repair |
| Kazuya Horike |
Yoshio Fukata |
Masashi Kanoh |
| Atsushi Kurushima |
|
|
(Department of Cardiovascular Surgery, National
Zentsuji Hospital, Kagawa, Japan)
|
A 36-year-old man was admitted to
our hospital due to infectious endocarditis and severe mitral
regurgitation caused by a prolapsed anterior leaflet. Mitral
valve repair with chordal replacement using expanded polytetrafluoroethylene
was performed and the post operative course was uneventful. One
year after the first operation, he was readmitted with a high
fever and lumbargo. Echocardiography revealed vegetation on the
anterior mitral leaflet and computed tomography of the brain
showed cerebral infarction. Blood culture was positive for Staphylococcus
aureus. Inflammatory symptoms improved following multiple
antibiotic medication and the blood culture became negative.
Echocardiography demonstrated the disappearance of the vegetation,
but moderate grade mitral regurgitation remained. We performed
mitral valve replacement instead of repair because the infectious
lesion extensively destroyed the anterior mitral leaflet. In
order to determine the appropriate time for surgical treatment
of infectious endocarditis, we must consider several factors,
such as the effectiveness of antibiotic treatment, potential
cerebral complications, and the degree of damage to the valve
and surrounding structures.
Jpn. J. Cardiovasc. Surg. 31：198-201（2002) |
|
