治疗受感染的冷大象干假体由Propionibacterium引起的治疗:一个手术挑战
Laura Varela Barca1, Laura Esteban-Lucia2, Marta Tomás-Mallebrera3
1Cardiovascular Surgery Department, Instituto de Investigación Sanitaria - Fundación Jiménez Diaz, Madrid, Spain.
Brazilian journal of cardiovascular surgery
|November 10, 2023
概括
一种罕见的Propionibacterium疹感染导致大动脉根衰变和心脏性休克,大动脉修复8年后. 紧急手术取代了移植,突出了复杂的大动脉手术中长期感染风险.
科学领域:
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
- 大动脉外科手术
背景情况:
- 复杂的大动脉病理需要先进的手术技术,如本塔尔 - 波诺手术和冷大象干 (FET) 假体.
- 内血管支架移植修复是下降大动脉问题的替代方案.
- 移植感染是主动脉重建后的一个严重并发症.
研究的目的:
- 在Bentall-Bono和FET植入后报告一个独特的晚期发病的Propionibacterium acnes移植感染病例.
- 描述这种罕见并发症的临床表现,诊断挑战和管理.
- 强调在大动脉手术后出现晚期并发症的患者考虑移植感染的重要性.
主要方法:
- 一个47岁的男性患者的病例报告.
- 医疗史的审查,包括本塔尔-博诺手术,FET假肢和先前的内血管修复.
- 诊断工作和紧急外科干预的详细描述.
主要成果:
- 在最初的手术后八年,由Propionibacterium acnes引起的亚急性移植感染的发展.
- 由于严重的大动脉反和由伪动脉瘤引起的大动脉根脱落而导致心脏性休克的呈现.
- 成功的紧急手术管理,包括用生物管替换移植物和分枝除枝的上大动脉血管.
结论:
- 晚期移植感染,即使有不寻常的病原体,如Propionibacterium acnes,也可能发生在复杂的大动脉手术后的几年.
- 大动脉根衰变和伪动脉瘤形成是移植感染的关键并发症.
- 积极的手术管理对于在这种先进的移植感染阶段的生存至关重要.
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