초록접수 현황
| 17F-288 | 포스터 발표 |
A Case Experience of Mitral Valve Reconstruction in a Patient with Native Mitral Valve Endocarditis having Extensive Valve Damage with Mycotic Cerebral Aneurysm
Yun Yi Bang, Sam-Sae Oh, Tae Yun Oh, Won Jin Lee
Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : Infective endocarditis (IE) is known as a disease with high rate of mortality and morbidity although surgery is undergone concomitantly with adequate antibiotic usage for the treatment. In general, mycotic aneurysm occurs in 15-20% of infective endocarditis, which is mainly located in cerebral artery. We are reporting a successful experience of mitral valve reconstruction in a patient with extensive valve damage with mycotic cerebral aneurysm.
Methods : A 17 year-old boy visited ER with severe abdominal pain. Diagnostic exams revealed IE with vegetation on both leaflets of mitral valve causing severe mitral regurgitation and subsequent splenic infarct, which was coincided with mycotic cerebral aneurysm. Simultaneous antibiotic treatment was followed by urgent surgery which included the removal of infected necrotic tissue with large amount of vegetation and mitral valve repair (C-E Physio ring 30mm) using bovine pericardium. During the surgery, low-dose heparin (200mg/kg) with target ACT level (480sec) was used for the prevention of cerebral complication.
Results : Postoperatively, the patient was generally in good condition without sequelae. His follow-up echocardiography demonstrated no regurgitation of mitral valve with normal LV function. Subsequently mycotic cerebral aneurysm was ligated a couple of weeks later after the initial operation.
Conclusion : We presented successful experience of mitral valve repair with adequate heparin usage and the subsequent ligation of cerebral aneurysm even in complicated infective endocarditis. Aggressive mitral valve reconstruction would be recommended in a patient with native mitral valve endocarditis having extensive valve damage with mycotic cerebral aneurysm.
Methods : A 17 year-old boy visited ER with severe abdominal pain. Diagnostic exams revealed IE with vegetation on both leaflets of mitral valve causing severe mitral regurgitation and subsequent splenic infarct, which was coincided with mycotic cerebral aneurysm. Simultaneous antibiotic treatment was followed by urgent surgery which included the removal of infected necrotic tissue with large amount of vegetation and mitral valve repair (C-E Physio ring 30mm) using bovine pericardium. During the surgery, low-dose heparin (200mg/kg) with target ACT level (480sec) was used for the prevention of cerebral complication.
Results : Postoperatively, the patient was generally in good condition without sequelae. His follow-up echocardiography demonstrated no regurgitation of mitral valve with normal LV function. Subsequently mycotic cerebral aneurysm was ligated a couple of weeks later after the initial operation.
Conclusion : We presented successful experience of mitral valve repair with adequate heparin usage and the subsequent ligation of cerebral aneurysm even in complicated infective endocarditis. Aggressive mitral valve reconstruction would be recommended in a patient with native mitral valve endocarditis having extensive valve damage with mycotic cerebral aneurysm.
책임저자: Sam-Sae Oh
Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Yun Yi Bang, E-mail : beebee732@naver.com