李玲,杨静,姜英,方理刚

• 1:中国医学科学院北京协和医学院北京协和医院心内科
• 2:中国医学科学院北京协和医学院北京协和医院病理科

摘要(Abstract)：

目的分析经导管封堵器置入术后迟发(术后≥6个月)感染性心内膜炎(IE)的临床特点。方法报道北京协和医院收治的1例封堵器置入术后8年发生IE的病例,并分析国内外数据库中经导管封堵器置入术后迟发IE的病例特点。结果北京协和医院1例23岁女性,房间隔缺损封堵术后8年出现发热,脑栓塞,超声心动图示封堵器左心房面赘生物,给予抗感染及手术移除封堵器。文献报道经导管封堵器置入术后迟发IE 16例(男10例/女6例),其中房间隔缺损封堵术后9例,卵圆孔未闭封堵术后3例,二尖瓣人工瓣瓣周漏封堵术后2例,动脉导管未闭封堵术后1例,室间隔缺损封堵术后1例。发生IE时间为封堵术后7个月～16年,发热和栓塞是最常见的临床表现。发生IE前有6例感染,3例行牙科治疗。血培养最常见细菌是金黄色葡萄球菌。14例行手术治疗,术中所见与术前超声心动图检查基本吻合,8例存在封堵器内皮化不全。结论经导管封堵器置入术后患者长期有IE的风险,特别是出现感染情况时,发生IE后多数需手术治疗。封堵器内皮化不全可能与封堵术后迟发IE相关。

关键词(KeyWords)： 导管;封堵器;介入治疗;感染性心内膜炎

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李玲,杨静,姜英,方理刚

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