Key result
Aortic valve replacement with the Perceval sutureless valve successfully treated an 87-year-old woman with healed prosthetic valve endocarditis, leading to reduction of a sinus of Valsalva aneurysm.
Case Report (n=1)
No
Aortic valve replacement with a Perceval sutureless valve may be an effective and less invasive option for high-risk elderly patients with healed prosthetic valve endocarditis and sinus of Valsalva aneurysm.
May offer option in select healed PVE reoperations; leaves open need for larger studies before wider adoption.
症例は87歳，女性．73歳時に大動脈弁狭窄症に対して大動脈弁置換術AVR（CEP 21 mm）を施行された．14年後に縦隔膿瘍に対して抗生剤を投与し，膿瘍の縮小傾向と炎症改善を認めた．その際に疣贅や大動脈弁逆流は認めなかった．その8カ月後に，呼吸苦を主訴に救急搬送された．精査の末，大動脈弁位で重度の弁逆流を認めた．疣贅は認めなかった．造影CTでは左バルサルバ洞動脈瘤を認めた．バルサルバ洞動脈瘤を伴う治癒後の大動脈弁位人工弁心内膜炎と診断した．手術ではCEP弁を除去，CEP弁は右冠尖に相当する弁尖が破壊されていた．左バルサルバ洞の拡張を認めた．Percevalを留置した．術後順調に経過していたが，房室解離を認め，ペースメーカーを留置した．経胸壁心臓超音波検査を施行し，大動脈弁位の人工弁機能に問題がないことを確認し，造影CTでは左バルサルバ洞動脈瘤の縮小を認めた．術後30日目に退院した．人工弁心内膜炎という高リスク症例に対してPercevalによる大動脈弁置換術が有効である．
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Takehara et al. (2023) conducted a case report in Healed aortic prosthetic valve endocarditis with an aneurysm of the sinus of Valsalva (n=1). Aortic valve replacement with Perceval sutureless valve was evaluated on Clinical recovery and aneurysm reduction. Aortic valve replacement with the Perceval sutureless valve successfully treated an 87-year-old woman with healed prosthetic valve endocarditis, leading to reduction of a sinus of Valsalva aneurysm.
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