心腔内に穿破したValsalva洞仮性動脈瘤を伴う感染性心内膜炎の1例

Infective Endocarditis with Pseudoaneurysms of the Sinus of Valsalva Ruptured into the Right Ventricle and the Left Atrium；Report of a Case

はじめに　感染性心内膜炎（IE）によりValsalva洞仮性動脈瘤を形成し，左房および右室流出路へ穿破して急速な心不全の悪化をきたした症例に対し，手術を施行して良好な経過が得られたので，文献的考察を加えて報告する．

A 65-year-old woman was admitted to our hospital with fever and left hemiplegia. She was diagnosed with infective endocarditis with multiple brain abscess. At first, heart failure was not present, and she was given medical treatment with antibiotics. But on day 12 after admission, she progressively developed heart failure. Transthoracic echocardiogram demonstrated pseudoaneurysm of the sinus of Valsalva, ruptured into the left atrium. At operation, another fistula to the right ventricular outflow tract was revealed. They were repaired with autologous pericardial patches, and the aortic valve was replaced with a bioprosthetic valve. The postoperative course was uneventful.