左室流出路の心室仮性瘤を合併した感染性心内膜炎の1例

Aortic Subannular Left Ventricular Pseudoaneurysm with Mitral Valve Regurgitation Due to Infective Endocarditis：Report of a Case

はじめに　感染性心内膜炎（IE）において，弁だけでなく弁輪やその周囲組織に破壊が波及した場合，多彩な病態を呈する．われわれは左室流出路に仮性左室瘤を形成した症例を経験したので報告する．

The patient was a 40-year-old male. His main complaints were fever and heart failure. Methicillin-sensitive Staphylococcus aureus was isolated from the patient’s blood culture. He was diagnosed with a left ventricular pseudoaneurysm by contrast-enhanced computed tomography （CT）. Severe mitral insufficiency and vegetation on the anterior mitral valve were observed on echocardiography. The patient went into shock and intratracheal intubation was performed. An intraaortic balloon pumping was started, and percutaneus cardiopulmonary support were established for cardiogenic shock. Mitral valve replacement with a mechanical valve and autologous pericardium patch closure were performed in an urgent surgery. Antibiotics were administered until his inflammatory response was negative. The patient had no recurrence of endocarditis or malfunction of the prosthetic valve and no leakage of the patchplasty for two years post-surgery.