판막주위농양에 의해 발생된 판막주위누출 환자에서 승모판막 치환술과 승모판륜 재건술을 함께 시행한 후 재발된 판막주위누출 - 1예 보고 -

Recurrent Paravalvular Leakage after Mitral Valve Replacement with Annular Reconstruction for Paravalvular Leakage Due to a Paravalvular Abscess - A case report -

  • 박찬범 (가톨릭대학교 의과대학 성바오로병원 흉부외과학교실) ;
  • 김용한 (가톨릭대학교 의과대학 성바오로병원 흉부외과학교실) ;
  • 권종범 (가톨릭대학교 의과대학 대전성모병원 흉부외과학교실) ;
  • 박건 (가톨릭대학교 의과대학 대전성모병원 흉부외과학교실) ;
  • 정미영 (가톨릭대학교 의과대학 성바오로병원 마취통증의학교실) ;
  • 진웅 (가톨릭대학교 의과대학 성바오로병원 흉부외과학교실) ;
  • 노태호 (가톨릭대학교 의과대학 성바오로병원 순환기내과학교실) ;
  • 김치경 (가톨릭대학교 의과대학 성바오로병원 흉부외과학교실)
  • Park, Chan-Beom (Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Yong-Han (Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kweon, Jong-Bum (Department of Thoracic and Cardiovascular Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Kuhn (Department of Thoracic and Cardiovascular Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chung, Mee-Young (Department of Anesthesiology, St. Paul's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jin, Ung (Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Roh, Tae-Ho (Division of Cardiology, Department of Internal Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Chi-Kyung (Department of Thoracic and Cardiovascular Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea)
  • 발행 : 2008.04.05

초록

판막주위농양은 판막륜과 주변조직의 감염성 괴사로 인하여 판막을 치환하기 전에 괴사된 조직의 제거와 첩포 재건술이 필요한 경우로 정의되며, 수술사망률과 합병증 및 재발률이 높은 것으로 알려져 있다. 본원에서는 13년전에 기계판막으로 승모판막치환술을 받은 59세 여자 환자에서 외래 추적 관찰중 발견된 판막주위농양에 의한 판막주위누출로 승모판륜재건술과 함께 승모판막치환술을 시행 받았으나, 술후 15병일째 판막주위누출이 재발하여 다시 승모판륜재건술 및 승모판막치환술을 시행 한 경우를 치험하여 보고하며, 환자는 수술후 8개월째 외래 경과관찰중이다.

Paravalvular abscess is defined as infective necrosis of the mitral annulus and surrounding tissue that requires debridement of the necrotic tissue and patch reconstruction before valve implantation. Paravalvular abscess is associated with high operative mortality, postoperative complications, and recurrence. We report here a case of a 59-year old woman that had undergone mitral valvular replacement with a mechanical valve 13 years ago. The patient was determined to have paravalvular leakage due to paravalvular abscess as seen during follow-up. The patient underwent repeat mitral valvular replacement with annular reconstruction. However, the patient with mitral annular reconstruction and valvular replacement on the fifteenth postoperative day due to recurrence of paravalvular leakage. The patient is now receiving follow-up eight months after surgery.

키워드

참고문헌

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