Surgical Treatment for Prosthetic Infective Endocarditis Complicated by Superior Mesenteric Artery Embolism

Hiroki Ikeuchi＊	Kenji Mogi＊	Manabu Sakurai＊
Yoshiharu Takahara＊

（Division of Cardiovascular Surgery, Institution of Cardiovascular Center, Funabashi Municipal Medical Center, Funabashi, Japan）

A 75-year-old man, who had undergone aortic valve and ascending aorta replacement at the age of 73 years, was admitted to our hospital with one week of fever. Blood culture showed growth of Streptococcus bovis and echocardiography showed vegetation on the prosthetic valve. Although antibiotic treatment was commenced, he complained of abdominal pain, and computed tomography showed a superior mesenteric artery embolism. The abdominal pain improved with fasting, but echocardiography showed another vegetation, and re-aortic valve replacement was performed to prevent embolism recurrence. When he resumed eating postoperatively, he again complained of abdominal pain and computed tomography showed mesenteric ischemia. The necrotic intestine was extensively resected and he recovered successfully. A superior mesenteric artery should be revascularized to 2/11 prevent perioperative mesenteric ischemia when cardiac surgery complicated by acute superior mesenteric artery embolism is performed.

 

Jpn. J. Cardiovasc. Surg. 46:169-172（2017）

Keywords：infective endocarditis;prosthetic valve infection;superior mesenteric artery embolism