1.A Case of Tricuspid Valve Endocarditis Complicated with Severe Lung Abscess
Hiroharu Shinjo ; Koki Takahashi ; Masahiro Tanji
Japanese Journal of Cardiovascular Surgery 2017;46(6):301-304
A 25-year-old woman with a history of atopic dermatitis was admitted to hospital with shortness of breath, high fever, cough, and bloody sputum. Chest X-ray showed a diffuse infiltrative shadow. We diagnosed pneumonia, and antibacterial therapy was started ; however, the treatment was ineffective. Echocardiography showed tricuspid endocarditis, and she was thus transferred to our hospital. We selected medical treatment because the case was complicated with severe lung abscesses and pulmonary failure. As a result of appropriate antibacterial medication for 4 weeks, her symptoms and lung abscesses were improved ; however, tricuspid regurgitation and right heart failure continued to worsen. Therefore, the patient underwent vegetectomy and tricuspid valve plasty. No perioperative pulmonary complication was observed. She continued to receive the same antibacterial treatment after 2 weeks. In preceding antibacterial treatment before surgical treatment, it is effective for tricuspid endocarditis complicated with severe lung abscess.
2.A Case of Double-Patch Closure for Left Ventricular Pseudo-False Aneurysm Following Subacute Myocardial Infarction
Hiroharu Shinjo ; Hirono Satokawa ; Shinya Takase ; Yuki Seto ; Takashi Igarashi ; Akihito Kagoshima ; Tsuyoshi Fujimiya ; Hitoshi Yokoyama
Japanese Journal of Cardiovascular Surgery 2015;44(2):70-73
A 65-year-old man was admitted with subacute myocardial infarction. During medical treatment, the patient lost consciousness as a result of an atrioventricular block and underwent an operation for an emergency percutaneous coronary intervention in the right coronary artery. In a follow-up examination, transthoracic echocardiography and computed tomography showed a left ventricular pseudo-false aneurysm, and therefore another operation was carried out. The operative findings showed that the heart markedly adhered to the pericardium and the aneurysm at the apex. The patient then underwent a double-patch closure of the ruptured point using an equine pericardial patch and a Dacron patch. No perioperative complication was observed. Left ventricular pseudo-false aneurysm is a rare complication following myocardial infarction. Here, we report a successful case of a double-patch closure of a pseudo-false aneurysm.
3.A Case of Type A Aortic Dissection That Developed Ischemic Cardiomyopathy due to Coronary Malperfusion
Emi NAGATA ; Takashi IGARASHI ; Hirono SATOKAWA ; Tsuyoshi FUJIMIYA ; Hiroharu SHINJO ; Keiichi ISHIDA ; Hitoshi YOKOYAMA
Japanese Journal of Cardiovascular Surgery 2021;50(4):279-282
A 57-year-old man complained of dyspnea, and his echocardiography showed diffuse severe left ventricular dysfunction. Five days after admission and starting the treatment for congestive heart failure, a computed tomography pointed out DeBakey type 1 aortic dissection with a patent false lumen incidentally. The ostium of the left coronary artery was compressed with the false lumen, and this finding was thought to be a cause of development of left ventricular dysfunction. A modified Bentall procedure with bioprosthesis and total arch replacement were performed. The patient was discharged on the 28th postoperative day without any complications.