Surgical Treatment for Prosthetic Infective Endocarditis Complicated by Superior Mesenteric Artery Embolism
- VernacularTitle:術前に上腸間膜動脈塞栓症を合併した大動脈弁位人工弁感染性心内膜炎の1例
- Author:
Hiroki Ikeuchi
;
Kenji Mogi
;
Manabu Sakurai
;
Yoshiharu Takahara
- Keywords: infective endocarditis; prosthetic valve infection; superior mesenteric artery embolism
- From:Japanese Journal of Cardiovascular Surgery 2017;46(4):169-172
- CountryJapan
- Language:Japanese
-
Abstract:
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.