Key result
Surgical resection and valve repair successfully resolves TV IE complicated by systemic embolization via PFO.
Case Report (n=1)
No
In cases of right-sided endocarditis with systemic embolism, the presence of a patent foramen ovale should be considered and appropriate surgical timing determined to prevent further embolization.
Highlights potential PFO role in right-sided IE embolization; hypothesis-generating and should not yet change practice.
卵円孔開存を伴う三尖弁位感染性心内膜炎で，疣腫散布により多発梗塞，多発膿瘍を合併した症例を経験した．症例は28歳，女性．熱発および全身の関節痛を主訴に救急外来を受診した．CT，MRI検査にて脳梗塞，多発肺膿瘍，化膿性脊椎炎，腓腹筋膿瘍を認めた．心エコー検査では三尖弁に25 mm大の疣腫の付着と同弁の逆流を認め，感染性心内膜炎と診断され，同時に卵円孔開存の存在が判明した．血液培養ではメチシリン感受性ブドウ球菌（MSSA）が確認された．約5週間の抗生剤による保存的加療を行った後，疣腫除去術，Kay法による三尖弁形成術および卵円孔閉鎖術を施行した．術後は7週間の抗生剤投与を施行し，軽快退院となった．以後，感染性心内膜炎，多発梗塞の再燃を認めていない．三尖弁位感染性心内膜炎において，疣腫散布による左心系への合併症を併発した場合，卵円孔開存の存在を念頭に置くとともに，適切に手術時期を判断し対処することが肝要である．
No takes yet. Share an insight, caveat, or question.
Tanaka et al. (2016) conducted a case report in Tricuspid valve infective endocarditis with patent foramen ovale (n=1). Surgical resection of vegetation, tricuspid valve repair, and direct closure of patent foramen ovale was evaluated on Clinical recovery without further endocarditis or embolism. A 28-year-old woman with tricuspid valve infective endocarditis and a patent foramen ovale complicated by systemic embolization was successfully treated with surgical resection and valve repair.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: