A Case of Embolomycotic Aneurysm and Mitral Insufficiency Due to Infective Endocarditis.
10.4326/jjcvs.26.190
- VernacularTitle:外腸骨動脈塞栓部がりゅう化した感染性心内膜炎による僧帽弁閉鎖不全の１例
- Author:
Shigeru Hosaka
;
Shoji Suzuki
;
Seiichiro Katahira
;
Hidenori Inoue
;
Shunya Shindo
;
Shinpei Yoshii
;
Kihachiro Kamiya
;
Yusuke Tada
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1997;26(3):190-192
- CountryJapan
- Language:Japanese
-
Abstract:
A 64-year-old man was admitted with intermittent high fever of 4 months duration and with three episodes of arterial embolism in the previous 2 months. Several investigations revealed evidence that those episodes involving bilateral popliteal arteries and the left external iliac artery originated from mycotic emboli. Severe mitral insufficiency due to infective endocarditis was also recognized. The ischemic symptoms improved after medical treatment. Despite antibiotic therapy for 4 weeks, inflammatory signs did not subside. Since aneurysm formation of the left external iliac artery at the embolized portion was detected on CT, mitral valve replacement and aneurysmectomy with femoro-femoral grafting were done concomitantly. Inflammatory signs disappeared immediately after the operation. Pathological findings indicated organization of the mitral vegetation and evidence of active infection in the aneurysm wall. Though aneurysmal change of a symptomatic embolized site is not common, the preoperative evaluation of possible associated mycotic aneurysm is important to decide on surgical strategy for infective endocarditis complicated by embolism.
