Replacement of four valves, a patient with the successful treatment of Cardiology of Beijing Union Hospital for infective endocarditis patients

"Thanks to Xiehe and dragged me back from the Ghost Gate!" Xiao Wu, who dropped more than twenty pounds before the operation, rose more than a dozen pounds a month after the operation. Recently, patients with a heart surgery of Beijing Union Hospital cured a patient with all four valves in the heart and infective endocarditis who had appeared in the heart -derived liquid liquid. The cardiac surgery team has successfully replaced four valves without controlling their infections and extremely unfavorable surgical conditions. Xiaowu has been discharged from the hospital in the near future.

In March 2022, Xiaowu, 33, began to have a fever repeatedly. Because of the busy work, I take antipyretics every time. After carrying more than a month, Xiaowu began to have multiple edema and decreased urine volume. At this time, he realized the seriousness of the condition and went to the hospital for treatment. Xiaowu, who had found Four Cyneys from an early age, recovered through surgery 16 years ago. He thought that after surgery, heart disease was completely "insulated" with himself. Unexpectedly, a cold, letting the disease entangle the heart that he was not strong.

This time, Xiaowu was diagnosed with infective endometritis, which was one of the recognized "fatal infectious disease syndrome". For more than a month of anti -infection treatment in the foreign hospital, Xiao Wu's weight dropped more than 20 pounds. He was exhausted when he went to the bathroom. The contempt of the heart valve continued to fall off, and multiple pulmonary embolism and pulmonary abscess had been formed. Xiao Wu's situation is getting worse and worse. Friends suggest that he came to Beijing Union Hospital.

For patients with infectious endometritis who are not effective or accompanied by complications, surgery is the last hope. However, the interrelationship between surgical indications, surgery risks and the timing of surgery is very complicated. At present, there are no unified guidelines in my country.

Miao Qi, the director of the Surgery, took the consultation and quickly arranged for her hospitalization. At this time, Xiaowu had severe malnutrition, electrolyte disorders, moderate anemia, and abnormal liver function. Cardiac ultrasound reminders: Following the three valve and pulmonary valve, the aortic valve also occurred, and the condition made obvious progress.

▲ Before surgery, Xiaowu was extremely thin. Zhao Yanxue Photo

Can you surgery? The cardiac surgery team fell into a dilemma. Xiaowu has the situation of lung abscess, sepsis, and low immunity. If surgery is immediately surgery, the risk of postoperative valve infection is high. Moreover, Xiaowu's congenital malformation heart has undergone a major surgery, and can they stand the challenge of the second major surgery? If the anti -infection treatment is continued, the biosi on the aortic valve will fall off at any time, and it may be emboced with important organs and endanger life. Xiaowu has appeared obvious heart failure, and if the condition continues to deteriorate, it will also endanger life.

Under the strong requirements of patients and their families, after comprehensive examination, full discussion and complete plan, Cardiology decided to let go. Multi -disciplinary teams such as infection, clinical nutrition, anesthesiology operating room, blood transfusion, and ICU also give support to help Xiaowu actively find pathogens, use antibiotics, correct heart failure and malnutrition, and improve anemia.

Although it is already prepared, the perisides still shocked the cardiac surgery team: Xiaowu's three -pointed and pulmonary valve has been completely eroded and damaged by bacteria, completely losing the function of the valve. Bacteria also infected a small defect of the aortic valve, a valve and a valve and a room interval. The four valves of the heart were infected by bacteria, and no literature was reported.

Xiaowu, who is extremely weak in the body, has a limited tolerance time to surgery. How to reduce the functions of surgical trauma, shorten surgical time, and coordinate four artificial valves, can be referred to without previous medical experience, and can only rely on the current judgment of the surgeon.

▲ Director Miao Qi (second from left) led the team to intense surgery. Photo by Sun Liang

With the superb surgical skills and excellent psychological quality, the surgery team has been successfully completed with its superb surgical skills and excellent psychological quality. Under the postoperative support and management of the ICU team, the second day after surgery, Xiao Wu broke away from the danger of life. "Thanks to Xiehe and dragged me back from the Ghost Gate!" At present, Xiao Wu has been discharged smoothly and recovered well.

Relying on the international leading patients with severe infectious heart endometritis, Xiehe Cardiac Surgery summarizes rich clinical experience and evidence -based evidence, and takes the lead in promoting the international consensus of acute period surgery of infective endometritis in China. Earlier, the academic circles generally believed that the risk of infectious endometriosis surgery was less risk. However, more and more evidence shows that the application time of antibiotics before surgery does not affect the mortality rate and the recurrence rate of infectious heart endometritis. Director Miao Qi said that as long as the surgical timing and method of endocarditis can effectively reduce the mortality of the perinatal period.

(Guangming Daily All -Media Reporter Cui Xingyi Correspondent Liu Jianzhou Zhao Yan Xue Xuezhuzhu)

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