周囲組織破壊を伴う大動脈弁位感染性心内膜炎の外科治療
大動脈弁位活動性心内膜炎では，弁輪から周囲に感染が波及し弁輪周囲膿瘍や仮性瘤，心腔への瘻孔形成などの多彩な病態を呈することが多く，高度心不全や臓器障害をきたす前に手術を施行することが重要である．外科治療においては，十分な感染巣や壊死組織のデブリードメントの後に弁輪や周囲組織を再建する．多くの場合は基部置換術を施行する必要があり，弁の選択にはホモグラフト，ステントレス弁，compositeグラフト，ロス手術などがあるが，その優劣についてはいまだに議論がある．...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 51; no. 6; pp. xii - xvii |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本心臓血管外科学会
15.11.2022
|
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.51.xii |
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| Abstract | 大動脈弁位活動性心内膜炎では，弁輪から周囲に感染が波及し弁輪周囲膿瘍や仮性瘤，心腔への瘻孔形成などの多彩な病態を呈することが多く，高度心不全や臓器障害をきたす前に手術を施行することが重要である．外科治療においては，十分な感染巣や壊死組織のデブリードメントの後に弁輪や周囲組織を再建する．多くの場合は基部置換術を施行する必要があり，弁の選択にはホモグラフト，ステントレス弁，compositeグラフト，ロス手術などがあるが，その優劣についてはいまだに議論がある． |
|---|---|
| AbstractList | 大動脈弁位活動性心内膜炎では，弁輪から周囲に感染が波及し弁輪周囲膿瘍や仮性瘤，心腔への瘻孔形成などの多彩な病態を呈することが多く，高度心不全や臓器障害をきたす前に手術を施行することが重要である．外科治療においては，十分な感染巣や壊死組織のデブリードメントの後に弁輪や周囲組織を再建する．多くの場合は基部置換術を施行する必要があり，弁の選択にはホモグラフト，ステントレス弁，compositeグラフト，ロス手術などがあるが，その優劣についてはいまだに議論がある． |
| Author | 松宮, 護郎 |
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| Copyright | 2022 特定非営利活動法人 日本心臓血管外科学会 |
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| References | 14) Kim JB, Ejiofor JI, Yammine M et al. Are homografts superior to conventional prosthetic valves in the setting of infective endocarditis involving the aortic valve ?. J Thorac Cardiovasc Surg 2016; 151: 1239-46. 12) Habib G, Lancellotti P, Antunes MJ et al. 2015 ESC guidelines for the management of infective endocarditis. The task force for the management of infective endocarditis of the European Society of Cardiology (ESC)endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015; 36: 3075-128. 17) Heinz A, Dumfarth J, Ruttmann-Ulmer E et al. Freestyle root replacement for complex destructive aortic valve endocarditis. J Thorac Cardiovasc Surg 2014; 147: 1265-70. 4) Anguera I, Miro JM, Evangelista A et al. Periannular complications in infective endocarditis involving native aortic valves. Am J Cardiol 2006; 98: 1254-60. 10) Sabik JF, Lytle BW, Blackstone EH et al. Aortic root replacement with cryopreserved allograft for prosthetic valve endocarditis. Ann Thorac Surg 2002; 74: 650-9. 6) Anguera I, Miro JM, Vilacosta I et al. Aorto-cavitary fistulous tract formation in infective endocarditis: clinical and echocardiographic features of 76 cases and risk factors for mortality. Eur Heart J 2005; 26: 288-97. 19) Sponga S, Daffarra C, Pavoni D et al. Surgical management of destructive aortic endocarditis: left ventricular outflow reconstruction with the sorin pericarbon freedom stentless bioprosthesis. Eur J Cardiothorac Surg 2016; 49: 242-8. 21) Leyh RG, Knobloch K, Hagl C et al. Replacement of the aortic root for acute prosthetic valve endocarditis: prosthetic composite versus aortic allograft root replacement. J Thorac Cardiovasc Surg 2004; 127: 1416-20. 26) Forteza A, Centeno J, Ospina V et al. Outcomes in aortic and mitral valve replacement with intervalvular fibrous body reconstruction. Ann Thorac Surg 2015; 99: 838-46. 30) Leontyev S, Borger MA, Modi P et al. Surgical management of aortic root abscess: a 13-year experience in 172 patients with 100% follow-up. J Thorac Cardiovasc Surg 2012; 143: 332-7. 18) Yang B, Caceres J, Farhat L et al. Root abscess in the setting of infectious endocarditis: short- and long-term outcomes. J Thorac Cardiovasc Surg 2021; 162: 1049-59. 27) Manouguian S, Kirchhoff PG. Patch enlargement of the aortic and the mitral valve rings with aortic-mitral double-valve replacement. Ann Thorac Surg 1980; 30: 396-9. 3) Baumgartner FJ, Omari BO, Robertson JM et al. Annular abscesses in surgical endocarditis: anatomic, clinical, and operative features. Ann Thorac Surg 2000; 70: 442-7. 24) Moon MR, Miller DC, Moore KA et al. Treatment of endocarditis with valve replacement: the question of tissue versus mechanical prosthesis. Ann Thorac Surg 2001; 71: 1164-71. 29) Elgharably H, Hakim AH, Unai S et al. The incorporated aortomitral homograft for double-valve endocarditis: the ‘hemi-commando’ procedure. Early and mid-term outcomes. J Cardiothorac Surg 2018; 53: 1055-61. 11) Witten JC, Houghtaling PL, Shrestha NK et al. Aortic allograft infection risk. J Thorac Cardiovasc Surg 2021. doi: 10.1016/j.jtcvs.2021.04.086. 23) Raman J, Lai DT, Dobrilovic N et al. Dacron skirt reconstruction of the left ventricular outflow tract: extending the capabilities of a valved conduit. Ann Thorac Surg 2017; 103: e97-9. 15) Abdelsattar ZM, Elsisy MF, Schaff H et al. Comparative effectiveness of mechanical valves and homografts in complex aortic endocarditis. Ann Thorac Surg 2021; 111: 793-9. 20) Melina G, De Robertis F, Gaer JA et al. Long-term survival after xenograft versus homograft aortic root replacement: results from a prospective randomized trial. J Thorac Cardiovasc Surg 2019. doi: 10.1016/j.jtcvs.2019.09.119 1) Pettersson GB, Coselli JS, Pettersson GB et al. 2016 the American Association for Thoracic Surgery (AATS) consensus guidelines: surgical treatment of infective endocarditis: executive summary. J Thorac Cardiovasc Surg 2017; 153: 1241-58. 5) Anguera I, Miro JM, San Roman JA et al. Periannular complications in infective endocarditis involving prosthetic aortic valves. Am J Cardiol 2006; 98: 1261-8. 8) David TE, Komeda M, Brofman PR. Surgical treatment of aortic root abscess. Circulation 1989; 80(3 Pt 1): I269-74. 7) Danielson GK, Titus JL, DuShane JW. Successful treatment of aortic valve endocarditis and aortic root abscesses by insertion of prosthetic valve in ascending aorta and placement of bypass grafts to coronary arteries. J Thorac Cardiovasc Surg 1974; 67: 443-9. 28) Pettersson GB, Hussain ST, Ramankutty RM et al. Reconstruction of fibrous skeleton: technique, pitfalls and results. Multimed Man Cardiothorac Surg, 2014. DOI: 10.1093/mmcts/mmu004 9) Chen GJ, Lo WC, Tseng HW et al. Outcome of surgical intervention for aortic root abscess: a meta-analysis. Eur J Cardiothorac Surg 2018; 53: 807-14. 2) Hill EE, Herijgers P, Herregods MC et al. Evolving trends in infective endocarditis. Clin Microbiol Infect 2006; 12: 5-12. 16) El-Hamamsy I, Clark L, Stevens LM et al. Late outcomes following freestyle versus homograft aortic root replacement: results from a prospective randomized trial. J Am Coll Cardiol 2010; 55: 368-76. 25) Schmidtke C, Dahmen G, Sievers HH. Subcoronary ross procedure in patients with active endocarditis. Ann Thorac Surg 2007; 83: 36-9. 22) Jassar AS, Bavaria JE, Szeto WY et al. Graft selection for aortic root replacement in complex active endocarditis: does it matter ?. Ann Thorac Surg 2012; 93: 480-7. 13) Savage EB, Saha-Chaudhuri P, Asher CR et al. Outcomes and prosthesis choice for active aortic valve infective endocarditis: analysis of the Society of Thoracic Surgeons adult cardiac surgery database. Ann Thorac Surg 2014; 98: 806-14. |
| References_xml | – reference: 6) Anguera I, Miro JM, Vilacosta I et al. Aorto-cavitary fistulous tract formation in infective endocarditis: clinical and echocardiographic features of 76 cases and risk factors for mortality. Eur Heart J 2005; 26: 288-97. – reference: 26) Forteza A, Centeno J, Ospina V et al. Outcomes in aortic and mitral valve replacement with intervalvular fibrous body reconstruction. Ann Thorac Surg 2015; 99: 838-46. – reference: 3) Baumgartner FJ, Omari BO, Robertson JM et al. Annular abscesses in surgical endocarditis: anatomic, clinical, and operative features. Ann Thorac Surg 2000; 70: 442-7. – reference: 10) Sabik JF, Lytle BW, Blackstone EH et al. Aortic root replacement with cryopreserved allograft for prosthetic valve endocarditis. Ann Thorac Surg 2002; 74: 650-9. – reference: 30) Leontyev S, Borger MA, Modi P et al. Surgical management of aortic root abscess: a 13-year experience in 172 patients with 100% follow-up. J Thorac Cardiovasc Surg 2012; 143: 332-7. – reference: 12) Habib G, Lancellotti P, Antunes MJ et al. 2015 ESC guidelines for the management of infective endocarditis. The task force for the management of infective endocarditis of the European Society of Cardiology (ESC)endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015; 36: 3075-128. – reference: 15) Abdelsattar ZM, Elsisy MF, Schaff H et al. Comparative effectiveness of mechanical valves and homografts in complex aortic endocarditis. Ann Thorac Surg 2021; 111: 793-9. – reference: 23) Raman J, Lai DT, Dobrilovic N et al. Dacron skirt reconstruction of the left ventricular outflow tract: extending the capabilities of a valved conduit. Ann Thorac Surg 2017; 103: e97-9. – reference: 28) Pettersson GB, Hussain ST, Ramankutty RM et al. Reconstruction of fibrous skeleton: technique, pitfalls and results. Multimed Man Cardiothorac Surg, 2014. DOI: 10.1093/mmcts/mmu004 – reference: 9) Chen GJ, Lo WC, Tseng HW et al. Outcome of surgical intervention for aortic root abscess: a meta-analysis. Eur J Cardiothorac Surg 2018; 53: 807-14. – reference: 25) Schmidtke C, Dahmen G, Sievers HH. Subcoronary ross procedure in patients with active endocarditis. Ann Thorac Surg 2007; 83: 36-9. – reference: 5) Anguera I, Miro JM, San Roman JA et al. Periannular complications in infective endocarditis involving prosthetic aortic valves. Am J Cardiol 2006; 98: 1261-8. – reference: 22) Jassar AS, Bavaria JE, Szeto WY et al. Graft selection for aortic root replacement in complex active endocarditis: does it matter ?. Ann Thorac Surg 2012; 93: 480-7. – reference: 17) Heinz A, Dumfarth J, Ruttmann-Ulmer E et al. Freestyle root replacement for complex destructive aortic valve endocarditis. J Thorac Cardiovasc Surg 2014; 147: 1265-70. – reference: 14) Kim JB, Ejiofor JI, Yammine M et al. Are homografts superior to conventional prosthetic valves in the setting of infective endocarditis involving the aortic valve ?. J Thorac Cardiovasc Surg 2016; 151: 1239-46. – reference: 2) Hill EE, Herijgers P, Herregods MC et al. Evolving trends in infective endocarditis. Clin Microbiol Infect 2006; 12: 5-12. – reference: 7) Danielson GK, Titus JL, DuShane JW. Successful treatment of aortic valve endocarditis and aortic root abscesses by insertion of prosthetic valve in ascending aorta and placement of bypass grafts to coronary arteries. J Thorac Cardiovasc Surg 1974; 67: 443-9. – reference: 19) Sponga S, Daffarra C, Pavoni D et al. Surgical management of destructive aortic endocarditis: left ventricular outflow reconstruction with the sorin pericarbon freedom stentless bioprosthesis. Eur J Cardiothorac Surg 2016; 49: 242-8. – reference: 18) Yang B, Caceres J, Farhat L et al. Root abscess in the setting of infectious endocarditis: short- and long-term outcomes. J Thorac Cardiovasc Surg 2021; 162: 1049-59. – reference: 11) Witten JC, Houghtaling PL, Shrestha NK et al. Aortic allograft infection risk. J Thorac Cardiovasc Surg 2021. doi: 10.1016/j.jtcvs.2021.04.086. – reference: 20) Melina G, De Robertis F, Gaer JA et al. Long-term survival after xenograft versus homograft aortic root replacement: results from a prospective randomized trial. J Thorac Cardiovasc Surg 2019. doi: 10.1016/j.jtcvs.2019.09.119 – reference: 16) El-Hamamsy I, Clark L, Stevens LM et al. Late outcomes following freestyle versus homograft aortic root replacement: results from a prospective randomized trial. J Am Coll Cardiol 2010; 55: 368-76. – reference: 24) Moon MR, Miller DC, Moore KA et al. Treatment of endocarditis with valve replacement: the question of tissue versus mechanical prosthesis. Ann Thorac Surg 2001; 71: 1164-71. – reference: 21) Leyh RG, Knobloch K, Hagl C et al. Replacement of the aortic root for acute prosthetic valve endocarditis: prosthetic composite versus aortic allograft root replacement. J Thorac Cardiovasc Surg 2004; 127: 1416-20. – reference: 8) David TE, Komeda M, Brofman PR. Surgical treatment of aortic root abscess. Circulation 1989; 80(3 Pt 1): I269-74. – reference: 27) Manouguian S, Kirchhoff PG. Patch enlargement of the aortic and the mitral valve rings with aortic-mitral double-valve replacement. Ann Thorac Surg 1980; 30: 396-9. – reference: 4) Anguera I, Miro JM, Evangelista A et al. Periannular complications in infective endocarditis involving native aortic valves. Am J Cardiol 2006; 98: 1254-60. – reference: 13) Savage EB, Saha-Chaudhuri P, Asher CR et al. Outcomes and prosthesis choice for active aortic valve infective endocarditis: analysis of the Society of Thoracic Surgeons adult cardiac surgery database. Ann Thorac Surg 2014; 98: 806-14. – reference: 1) Pettersson GB, Coselli JS, Pettersson GB et al. 2016 the American Association for Thoracic Surgery (AATS) consensus guidelines: surgical treatment of infective endocarditis: executive summary. J Thorac Cardiovasc Surg 2017; 153: 1241-58. – reference: 29) Elgharably H, Hakim AH, Unai S et al. The incorporated aortomitral homograft for double-valve endocarditis: the ‘hemi-commando’ procedure. Early and mid-term outcomes. J Cardiothorac Surg 2018; 53: 1055-61. |
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| Title | 周囲組織破壊を伴う大動脈弁位感染性心内膜炎の外科治療 |
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