在门内膜TAVR内心炎之后,败血性冠状动脉栓塞和心肌断裂
Antonio D'Errico Ramirez1, Yves-Assad Saade1, Lujain Albadiech2
1Division of Cardio-Thoracic Surgery, CHU Reims, Reims, France.
JACC. Case reports
|October 24, 2025
概括
在门内TAVR之后的败血性冠状动脉栓塞是罕见的. 这一案例突出了心肌断裂的独特呈现,而没有吸管,强调多式成像用于早期诊断和挽救生命的手术干预.
科学领域:
- 心脏病学 心脏病学
- 传染性内心炎感染性内心炎
- 心脏外科手术 心脏外科手术
背景情况:
- 败血性冠状动脉栓塞是传染性内心炎的罕见并发症,特别是在门内透管大动脉置换 (TAVR) 后.
- 机械并发症,如伪动脉瘤或心肌断裂是非常罕见的TAVR后.
研究的目的:
- 报告一个不寻常的败血性冠状动脉栓塞病例导致心肌断裂.
- 为了突出多式成像在这种复杂的情况下的诊断实用性.
主要方法:
- 一名78岁的男性先前有了门内TAVR,出现了心肌梗塞的症状.
- 诊断工作包括冠状动脉扫描,血液培养,食管横断心声扫描和正子发射断层扫描-计算机断层扫描.
- 胸腔外心回声检查发现左心室自由壁伪动脉瘤,导致紧急手术.
主要成果:
- 血液培养物确定了Enterococcus faecalis,心声学显示了大动脉的植被.
- 阳子发射断层扫描-计算机断层扫描显示,脏和左心室壁的吸收增加.
- 患者患有血胸病和贫血,手术证实左心室破裂和腔空间通信.
结论:
- 这种病例表明了异常呈现的败血性冠状动脉栓塞,导致心肌断裂而没有吸管.
- 多式成像在诊断中起到了至关重要的作用.
- 警TAVR后传染性内心炎的结构性并发症对于及时,拯救生命的外科治疗至关重要.
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