“…We selected seven ASD device follow‐up studies , one meta‐analysis of percutaneous and surgical ASD closure , and two FDA databases . We identified twenty‐one cases of infective endocarditis following atrial septal device closure (Table ). Three studies did not meet the selection criteria (fungal endocarditis following ventricular septal defect hybrid procedure , atrial septal defect presenting with Brucella endocarditis , and patch abcess after surgical closure of an atrial septal defect ).…”
“…We selected seven ASD device follow‐up studies , one meta‐analysis of percutaneous and surgical ASD closure , and two FDA databases . We identified twenty‐one cases of infective endocarditis following atrial septal device closure (Table ). Three studies did not meet the selection criteria (fungal endocarditis following ventricular septal defect hybrid procedure , atrial septal defect presenting with Brucella endocarditis , and patch abcess after surgical closure of an atrial septal defect ).…”
Novel cardiac devices, including the MitraClip system, occluder devices, leadless pacemakers, and subcutaneous implantable cardioverter defibrillators (S-ICD), are mostly used in the management of patients who are at high risk for surgery and/or developing infections. Several mechanisms render most of these devices resistant to infection, including avoiding long transvenous access and novel manufacturing material. Since subjects who use these devices already endure several comorbid conditions, uncommon cases of device-associated infection could result in serious complications and increased mortality. In this review, we aim to summarize the current state of evidence on the incidence, clinical presentation, management, and prognosis of new cardiac devices' associated infection.
“…При рассмотрении большинства из уже описанных клинических случаев невоз-можно точно определить, в какой момент произошла бактериальная инвазия. Часть исследователей не исключают роли незавер-шённой эндотелизации окклюдера, что де-лает его более уязвимым к бактериальной инвазии и тромбированию [11,13,14].…”
РефератДефекты межпредсердной перегородки -вторые по частоте после дефектов межжелудочковой перегородки среди врождённых пороков сердца. Эндоваскулярное закрытие дефекта межпредсердной перегородки выпол-няют по строгим показаниям у пациентов со значимым сбросом крови слева направо. Развитие инфекционного эндокардита после транскатетерной имплантации окклюдера бывает чрезвычайно редким осложнением. В дан-ном клиническом наблюдении рассмотрен случай развития инфекционного эндокардита митрального клапана (с развитием выраженной недостаточности) через 13 лет после эндоваскулярного закрытия дефекта межпред-сердной перегородки у пациентки 39 лет. Перед выполнением хирургического вмешательства проведена ком-плексная антибиотикотерапия. В ходе операции выполнены удаление окклюдера дефекта межпредсердной пе-регородки, протезирование митрального клапана, пластика дефекта межпредсердной перегородки и резекция ушка левого предсердия. Послеоперационный период протекал без особенностей. Ключевые слова: окклюдер дефекта межпредсердной перегородки, инфекционный эндокардит, протезирова-ние митрального клапана, недостаточность митрального клапана.
Surgical removal of atrial septal defect occlusion device and mitral valve replacement in a 39-year-old female patient with infective endocarditis
A.S. Zotov, D.V. Borisov, T.V. Klypa, S.A. Vachev Federal Research Clinical Center for Specialized Types of Health Care and Medical Technologies of Federal Medical and Biology Agency, Moscow, RussiaAtrial septal defects represent the second most frequent congenital heart disease after ventricular septal defects. Transcatheter closure of an atrial septal defect is usually performed following strict indications on patients with significant left-to-right shunt. Infective endocarditis after transcatheter implantation of atrial septal defect occluder is an extremely rare complication. We report a case of infective endocarditis of the mitral valve (with severe mitral valve insufficiency) in a 39-year-old female patient 13 years after transcatheter closure of an atrial septal defect. Complex prophylactic antibiotic coverage was performed prior to surgical intervention. Surgical removal of atrial septal defect occluder, mitral valve replacement, atrial septal defect closure and left atrial appendage resection were performed. Postoperative course was uneventful. Keywords: atrial septal defect occluder, infective endocarditis, mitral valve replacement, mitral valve insufficiency.Адрес для переписки: dan-cer@inbox.ru Поступила 11.09.2017; принята в печать 03.10.2017.
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