Surgical Treatment with Fresh Autologous Pericardium for Tricuspid Valve Infective Endocarditis with Ventricle Septal Defect / 日本心臓血管外科学会雑誌

Right sided infective endocarditis (RSIE) is uncommon. Patients are traditionally treated with antibiotics alone, and indications for operation are not clearly established. A 23-years-old man who developed fever and general fatigue was referred to our hospital on the suspicion of RSIE. A ventricular septal defect (VSD) and untreated dental caries had been previously diagnosed. Transthoracic echocardiography revealed vegetation on the tricuspid valve and severe regurgitation. The tricuspid valve was repaired ; the anterosuperior leaflet was partially resected and repaired with fresh autologous pericardium and the use of synthetic chordae. Recurrence of infection and tricuspid valve regurgitation were not observed for 1 year after this operation.

Successful Surgical Treatment for Infective Endocarditis Involving the Aortic, Mitral, and Pulmonary Valves in a Patient with a Ventricular Septal Defect / 日本心臓血管外科学会雑誌

<p>A 46-year-old man who developed fever and general fatigue was referred to our hospital with suspicion of infective endocarditis. A ventricular septal defect had been previously diagnosed. Transthoracic echocardiography revealed vegetation on the aortic, mitral, and pulmonary valves, and each valve had significant regurgitation. An emergency operation was performed because of congestive heart failure. The aortic and mitral valves were replaced with mechanical valves. The pulmonary valve was repaired ; the anterior leaflet was resected and replaced by glutaraldehyde-treated autologous pericardium. The patient's postoperative course was uneventful. Recurrence of infection was not observed for 3 years after the operation. Triple-valve endocarditis, especially that involving a combination of the aortic, mitral, and pulmonary valves, is rare. Involvement of multiple valves on both sides of the heart may be attributed to a congenital intracardiac shunt. Early surgical intervention may be useful to control infection and heart failure, as in the present case.</p>

Platypnea-orthodeoxia syndrome in a patient with a pre-existing patent foramen ovale successfully treated with an atrial septal occluder / 老年心脏病学杂志（英文版）

Platypnea orthodeoxia syndrome is associated with dyspnea and arterial oxygen desaturation accentuated by an upright posture. It can be secondary to an intracardiac shunt. We report a case of platypnea-orthodeoxia syndrome (POS) in a 58-year old male patient who had a pre-existing patent foramen ovale (PFO) and substantial pulmonary pathologies. He was successfully treated by percutaneous transcatheter closure of the PFO. Our case highlights the importance of recognition of this rare syndrome in patients who present with unexplained hy-poxia for whom transcatheter closure of the interatrial shunt can be safely carried out.