Matsuki Y, Suzuki S, Isomatsu Y, Kasama K, Minami T, Masuda M
Department of Surgery, Yokohama City University, Yokohama, Japan.
Kyobu Geka. 2011 Apr;64(4):341-3.
A 77-year-old man on hemodialysis was admitted to our hospital due to heart failure. Echocardiography showed aortic valve stenosis and regurgitation, mitral valve stenosis and regurgitaion, and tricuspid valve regurgitation. Catheter examination revealed severe calcification at aortic valve and mitral valve including their annulus. At the operation, the calcifications of the aortic and mitral valvular annulus was removed using a cavitron ultrasonic surgical aspirator (CUSA). Reconstructions of the defect of the posterior part of the mitral annulus and of the aortic annulus at the site of the left coronary cusp were achieved by patch technique using autologous pericardium. Aortic and mitral valve replacement and tricuspid valve annuloplasty were performed. The postoperative course was uneventful. Operative technique to remove calcification from valvular annulus using CUSA and reconstruct of the defect of the annulus with autologous pericardium is a very useful technique to prevent left ventricular rupture, perivalvular leakage and any other complications.
一名77岁接受血液透析的男性因心力衰竭入住我院。超声心动图显示主动脉瓣狭窄并反流、二尖瓣狭窄并反流以及三尖瓣反流。心导管检查发现主动脉瓣和二尖瓣包括其瓣环严重钙化。手术中，使用超声外科吸引器（CUSA）清除主动脉瓣和二尖瓣瓣环的钙化。采用自体心包补片技术修复二尖瓣环后部和左冠状动脉瓣尖处主动脉瓣环的缺损。进行了主动脉瓣和二尖瓣置换以及三尖瓣瓣环成形术。术后过程顺利。使用CUSA从瓣环清除钙化并采用自体心包修复瓣环缺损的手术技术是预防左心室破裂、瓣周漏及其他并发症的非常有用的技术。
