A Case of Acute Arterial Occlusion of the Lower Extremity Caused by Huge Vegetation of Prosthetic Valve Endocarditis
10.4326/jjcvs.42.284
- VernacularTitle:人工弁感染性心内膜炎の巨大疣贅により急性下肢動脈閉塞をきたした1例
- Author:
Kizuku Yamashita
;
Tomoyuki Fujita
;
Hiroki Hata
;
Yusuke Shimahara
;
Shunsuke Sato
;
Junjiro Kobayashi
- Publication Type:Journal Article
- Keywords:
prosthetic valve endocarditis;
bacterial embolism;
vegetation;
acute arterial occlusion
- From:Japanese Journal of Cardiovascular Surgery
2013;42(4):284-288
- CountryJapan
- Language:Japanese
-
Abstract:
A 79-year-old woman with prosthetic valve endocarditis (PVE) on aortic position underwent re-aortic valve replacement. Although emergency operation was indicated due to huge vegetation over 20 mm in diameter attached to the prosthesis shown by preoperative transesophageal echocardiography, intraoperative transesophageal echocardiography showed disappearance of the vegetation. The prosthesis was carefully removed and replaced by a new bioprosthesis, though only small vegetation was observed on the removed prosthesis. Sudden blue toe 11 h after the operation and diminished pulse on right pedal artery suggested an acute arterial occlusion of a right lower extremity, requiring an emergency thrombectomy. Pathology diagnosed bacterial embolus with fresh thrombus that was considered apart from the prosthesis at the time of operation.
