肺動脈弁に疣贅を有する感染性心内膜炎に対して弁置換術を施行した1例

Valve Replacement for Infective Endocarditis of Pulmonary Valve；Report of a Case

一般的に感染性心内膜炎（IE）は左心系に多く認められる疾患であり，右心系のIEは全体の5～10％にすぎない1）．また，右心系のIEのうちほとんどの場合が三尖弁に発症する．要因としては，欧米では薬物乱用者，本邦では基礎心疾患を有する例，特に心室中隔欠損症での発症が多いとされている1）．われわれは，心房中隔欠損症（ASD）に合併して生じた肺動脈弁のIEの1例を経験したので報告する．

Generally, infective endocarditis is found at the left side of the heart. The right side infective endocaritis accounts for only 5～10％ of all cases of infective endocarditis. The right side infective endocarditis occurs especially among drug users employing intravenous injection. A typical site of infection is the tricupid valve, and isolated pulmonary valve involvement is rare. It is assumed that its rarity is due to the low pressure gradients within the right heart, the low prevalence of valve disease, and the lower oxygen content of the venous blood. We describe a case of isolated pulmonary valve endocarditis requiring valve replacement. Antibiotic therapy was conducted for 4 weeks before surgery and 2 weeks after surgery. Clinical course was favorable and the patent was discharged home 18 days after surgery.