Mitral Valve Plasty in the Active Phase of Infective Endocarditis with Intracerebral Mycotic Aneurysms and Abscesses in the Brain and Lower Limb
10.4326/jjcvs.36.19
- VernacularTitle:僧帽弁形成術後に感染性脳動脈瘤，脳膿瘍および下腿膿瘍がすみやかに改善した活動期感染性心内膜炎の１例
- Author:
Hiroshi Kagawa
;
Kazuhiro Hashimoto
;
Yoshimasa Sakamoto
;
Hiroshi Okuyama
;
Shinichi Ishii
;
Shingo Taguchi
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2007;36(1):19-22
- CountryJapan
- Language:Japanese
-
Abstract:
A 38-year-old woman was referred to our hospital for treatment of infective endocarditis associated with abscesses in the brain and the left lower limb. A causative organism had not been detected by serial blood cultures. Preoperative brain CT revealed mycotic aneurysms and echocardiography showed a mobile vegetation (8mm in size) on the anterior leaflet of the mitral valve. We performed resection of the vegetation together with a small triangle of the anterior leaflet, after which the margins of the defect were approximated. Then bilateral Kay procedures and reinforcement with autologous pericardium were done to obtain proper coaptation. The patient's fever, left lower limb pain, and intracerebral mycotic aneurysms resolved after surgery. The brain abscess also became smaller. Mitral valve plasty should sometimes be considered in the active phase of endocarditis, even in patients with cerebral complications and without congestive heart failure.
