大動脈弁下膿瘍を伴う感染性心内膜炎に対する膿瘍腔閉鎖と弁輪形成の1例

Successful Surgical Repair of the Aortic Annular Infective Endocarditis with Subvalvular Abscess；Report of a Case

はじめに　感染性心内膜炎は細菌集簇による弁尖・弁輪部の破壊を生じ，しばしば弁形成術・弁置換術を必要とする疾患である．破壊された弁輪の脆弱な組織に人工弁を縫合する場合，これが術後縫合不全の原因の一つとなる．われわれは弁尖の破壊に加え大動脈弁下膿瘍を形成した患者に対し，自己心膜を用いて膿瘍腔閉鎖と弁輪形成を行った症例を経験したので報告する．

A 49-year-old female was admitted to our hospital with a history of fever for 2 weeks and consciousness disorder．Transthoracic echocardiography demonstrated aortic regurgitation with a mobile fibrous band adhering to the right cusp. Infective endocarditis was diagnosed by positive blood culture and echocardiographic findings. Emergent aortic valve surgery was performed because of uncontrollable infection. A destroyed aortic annulus and subvalvular abscess was found during the operation. Removal of abscess tissue and annuloplasty with self-pericardium were successfully performed.