[A case report of infective endocarditis with acute pulmonary edema and renal dysfunction treated by emergent mitral valve replacement and postoperative extracorporeal ultrafiltration].
A 40-year-old woman with staphylococcus aureus endocarditis of the mitral valve associated with acute pulmonary edema and renal dysfunction is presented. The patient was admitted to Hiroshima University Hospital with infective endocarditis. On the 14th day after admission, she suffered from severe cardiac failure and oligouria, then she was transferred ICU. Chest X-ray film showed pulmonary congestion and echocardiogram revealed 4th grade of mitral valve regurgitation. Emergent mitral valve replacement was performed and rupture of anterior mitral chorda was found as the cause of acute pulmonary edema. Postoperative care was difficult because of advanced renal failure and cardiac failure not responded to diuretics. Extracorporeal ultrafiltration method was effectively used on the 1st and the 2nd postoperative days and 3000 ml of water was filtered without hemodynamic change. Symptoms of renal and cardiac failure recovered promptly after ultrafiltration. Emergent operative and postoperative use of ultrafiltration method is effective in some cases of infective endocarditis complicated with cardiac and renal failure.
Sueda
T
T
Komichi
Y
Y
Kawaue
Y
Y
Hamanaka
Y
Y
Ishihara
H
H
Matsuura
Y
Y
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000150:complications / Q000628:therapy*; D000328:Adult; D004630:Emergencies; D004697:Endocarditis, Bacterial / Q000150:complications / Q000601:surgery*; D005260:Female; D006341:Heart Rupture / Q000150:complications; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery; D011182:Postoperative Care; D011654:Pulmonary Edema / Q000209:etiology*; D014462:Ultrafiltration