| Japanese |
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| Title | 心内膜炎にて大動脈弁置換術(17mm SJM-HP弁)を施行したSLE, 慢性透析患者の経験 |
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| Subtitle | 症例 |
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| Authors | 大沢肇 |
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| Authors(kana) | |
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| Organization | 帝京大学市原病院心臓血管センター |
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| Journal | 循環制御 |
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| Volume | 24 |
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| Number | 2 |
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| Page | 150-154 |
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| Year/Month | 2003/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「緒言」透析患者の大動脈弁疾患は弁及び弁周辺の石灰化を伴うため小サイズの大動脈弁しか挿入できないことが多い. SLE(systemic lupus erythematosus)と慢性透析で感染性心内膜炎となり大動脈弁逆流を発症した症例に大動脈弁置換術を施行した. 使用報告の少ない狭小弁である17mm SJM(ST. JUDE MEDICAL)弁を使用したが突然死したので, その原因を考察し報告する. 「症例」症例は53歳の女性で主訴は呼吸困難であった. 既往歴では37歳からSLEと診断され, 4年前より透析導入した. 1年前人工血管による内シャントを作製した. 現病歴は6ヶ月前に内シャントが閉塞したために鼡径部に留置したカテーテルを用いて透析を行った. 4ヶ月前より微熱が続き, カテーテル培養でEnterococcus faecalisを検出した. 2ヶ月前急性心不全となり, 血液培養でもEnterococcus faecalis検出した. 入院時現症では体格中等度, BSA=1.29m2, 血圧126/60㎜mHg, 脈拍106beat/min整, 蝶型紅斑等のSLE特有の皮膚所見は認められなかった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | 17 mm St. Jude Medical-HP valve, SLE, Infectious endocarditis, Hemodialysis, Sudden death |
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| English |
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| Title | Aortic Valve Replacement with 17 mm St. Jude Medical-HP Valve Prosthesis Due to Infectious Endocarditis Combined with SLE and Chronic Renal Failure |
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| Subtitle | |
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| Authors | Hajime Osawa |
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| Authors(kana) | |
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| Organization | Cardiovascular Center Teikyo University Ichihara Hospital |
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| Journal | Circulation Control |
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| Volume | 24 |
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| Number | 2 |
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| Page | 150-154 |
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| Year/Month | 2003/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A 53 year-old female was diagnosed as SLE with chronic renal failure. She suffered from sepsis due to infective Enterococcus Fecalis. Echocardiography showed massive aortic regurgitation and aoric valve replacement was recommended. Operative findings showed fresh vegitation on the aortic leaflets and perforation of the right aortic leaflet. Aortic valve replacement was performed with a 17 mm prosthetic mechanical heart valve (St. Jude Medical, HP plus). The patient suddenly died during hemodialysis 16 days after the operation. We postulated that the cause of death was from ventricular arrhythmia which is a major contributor to unidentified deaths in HD patients. The prosthetic heart valve did not contribute to the sudden death. |
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| Practice | Basic medicine |
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| Keywords | 17 mm St. Jude Medical-HP valve, SLE, Infectious endocarditis, Hemodialysis, Sudden death |
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