Misawa Y, Hasegawa T, Kimura S
Department of Thoracic and Cardiovascular Surgery, Jichi Medical School.
Kyobu Geka. 1990 Apr;43(4):333-6.
A 38-year-old man was referred to our hospital because of a heart murmur and mild fever. Physical examination disclosed a systolic murmur of grade 3/6 at the apex and a diastolic murmur of grade 4/6 at the 2nd intercostal space of the left sternal border. The chest radiograph revealed mild cardiomegaly. The ECG showed left ventricular hypertrophy and ST segment depression in leads I, aVL and V4 to V6. Aortogram demonstrated supravalvular aortic stenosis (SAS) and aortic regurgitation. At the operation, we found the right coronary ostium was severely narrowed by the thickened right coronary cusp and the fibrous ring causing SAS. Aortic valve replacement and extended aortoplasty were performed. He had been doing well but suddenly died 11 months after the operation.
一名38岁男性因心脏杂音和低热被转诊至我院。体格检查发现心尖部有3/6级收缩期杂音，左胸骨缘第二肋间有4/6级舒张期杂音。胸部X线片显示轻度心脏扩大。心电图显示左心室肥厚，I、aVL及V4至V6导联ST段压低。主动脉造影显示瓣上主动脉狭窄（SAS）及主动脉瓣反流。手术中，我们发现增厚的右冠状动脉瓣叶和纤维环导致右冠状动脉口严重狭窄，引起SAS。进行了主动脉瓣置换和扩大主动脉成形术。他术后情况一直良好，但术后11个月突然死亡。
