周藤 弥生¹, 中村 憲司², 石塚　 尚子², 藤田 洋子², 仁木　 清美², 酒井 吉郎², 橋本 明政³

Yayoi SUTO¹, Kenji NAKAMURA², Naoko ISHIZUKA², Yoko HUJITA², Kiyomi NIKI², Kichiro SAKAI², Akimasa HASHIMOTO³

¹大阪市立総合医療センター循環器内科, ²東京女子医科大学循環器内科, ³東京女子医科大学心臓血管外科

¹Division of Cardiology, Osaka City General Hospital, ²Division of Cardilology, Tokyo Womens Medical University , ³Division of Cardiovascular Surgery, Tokyo Womens Medical University

キーワード : Aortic ring abscess, Infective endocarditis, Mitral valve aneurysm, Transesophageal echocardiography

A 33-year-old woman who had aortic valve replacement (AVR) because of infective endocarditis 2 years ago was referred to us with orthopnea and a new heart murmur. An aortic ring abscess and a mitral valve aneurysm were detected by transthoracic and transesophageal echocardiography. Abnormal flow through the aortic ring between the aorta and the left atrium was shown by color Doppler echocardiography. The condition was diagnosed as prosthetic valve endocarditis and was treated using the re-AVR translocation method (AVR translocated in the supracoronary area) (Carbo Medics, 23 mm) and mitral valve repeacement (Carbo Medics, 29 mm). Changes in size and number of aortic root abscesses after surgery were closely monitored by transthoracic and transesophageal echocardiography, which provides comprehensive infoemation about complex infective lesions.