Journal of Chest Surgery

  • 제36권10호
  • /
  • Pages.780-783
  • /
  • 2003
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지

대동맥판막재치환술 후 발생한 발살바동 파열을 동반한 심박조율도관 심내막염

Pacemaker Lead Endocarditis Combined with Rupture of Sinus Valsalva after Redo Aortic Valve Replacement

  • 백만종 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 나찬영 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 오삼세 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 김웅한 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 황성욱 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 이철 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 강창현 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 장윤희 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 조원민 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 김재현 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 서홍주 (부천세종병원 흉부외과, 세종심장영구소) ;
  • 김종환 (부천세종병원 흉부외과, 세종심장영구소)
  • Baek, Man-Jong (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Na, Chan-Young (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Oh, Sam-Se (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Kim, Woong-Han (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Whang, Sung-Wook (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Lee, Cheol (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Kang, Chang-Hyun (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Chang, Yun-Hee (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Jo, Won-Min (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Kim, Jae-Hyun (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Seo, Hong-Ju (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon) ;
  • Kim, Chong-Whan (Dept. of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Pucheon)
  • 발행 : 2003.10.01
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초록

심박조율도관 관련 심내막염은 드물지만 치명적인 합병증이다. 과거 기계판막을 이용한 이중판막치환술 및 영구 심박조율기 삽입 후 발생한 발살바동 파열이 있었던 45세 남자로 간헐적인 고열을 주소로 입원하였다. 혈액균배양 검사에서 streptococcus viridans 배양 및 경식도초음파 검사에서 조율도관 및 삼첨판막에 유동성이 있는 큰 증식물이 관찰되어 심박조율도관 관련 심내막염으로 진단하였다. 항생제 치료 후 조율도관의 제거술과 증식물 및 감염조직의 절제술을 시행하였다. 술 후 4주 동안 항생제 투여를 지속하였으며 경과는 양호하였다. 퇴원 후 심내막염의 재발 소견이나 증상없이 외래통원 치료중이다.

Pacemaker lead-related infective endocarditis is an uncommon, but serious complication. We report a case of a 45-year-old man who had symptom of intermittent high fever and rupture of sinus Valsalva that developed after a redo aortic valve replacement and transvenous permanent pacemaker implantation. Positive blood cultures of streptococcus viridans and transesophageal echocardiography showing a large mobile vegetation on pacemaker lead and tricuspid valve lead to the diagnosis of pacemaker lead-related infective endocarditis. Initial antibiotic therapy followed by surgical extraction of the pacemaker lead and wide debridement of infective tissues including multiple vegetations was required. Postoperative antibiotic therapy was continued for 4 weeks. The postoperative course has been uneventful. The patient is totally asymptomatic and is doing well up to now.

키워드

참고문헌

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