先天性心疾患を伴わない肺動脈弁位感染性心内膜炎に対する肺動脈弁置換術の1例

Valve Replacement for Isolated Pulmonary Valve Infective Endocarditis without Congenital Heart Defects：Report of a Case

はじめに　肺動脈弁位感染性心内膜炎（IE）はIE全体の1.5～2％と報告されており，その多くは背景として，心房中隔欠損（ASD）などの先天性心疾患を有する．われわれは先天性心疾患を伴わずに発症した肺動脈弁位IEに対して肺動脈弁置換術を行い，良好な結果を得たので報告する．

We report a rare case of isolated pulmonary valve endocarditis in a 60-year-old man without congenital heart defects. He had a persistent fever and back neck pain after pulling out his teeth. Echo cardiography revealed a mobile vegetation （measuring 53 mm in size） adhering to the pulmonary valve and blood cultures showed the presence of Staphylococcus aureus （S. aureus）. Because of mobile vegetation, pulmonic embolism and presence of S. aureus, surgical treatment was selected. During surgical procedure, we found that the vegetation had destroyed markedly pulmonary valve leaflets. After excising pulmonary valve leaflets, we implanted a bioprosthetic valve and enlarged the pulmonary artery with autologous pericardium. A year after surgery, the patient is stable with no sign of infection.