Hayashi Tomohiro, Amaki Makoto, Kanzaki Hideaki, Funada Akira, Sugano Yasuo, Ohara Takahiro, Takahama Hiroyuki, Hasegawa Takuya, Kitakaze Masafumi, Anzai Toshihisa
Cardiovascular Division of Medicine, National Cerebral and Cardiovascular Center, Japan.
Intern Med. 2013;52(24):2765-9. doi: 10.2169/internalmedicine.52.0999.
A 70-year-old man complaining of exertional dyspnea was referred to our hospital for recurrence of mitral regurgitation (MR) after mitral valve repair. Echocardiography revealed the presence of a bulging subaortic septum with flow acceleration in the left ventricular outflow tract (LVOT) and systolic anterior motion of the mitral valve with moderate MR, consistent with LVOT obstruction. Since medical therapy was not sufficiently effective, we performed percutaneous transluminal septal myocardial ablation (PTSMA). After the procedure, the MR resolved, with a reduced LVOT pressure gradient. The patient's symptoms improved. PTSMA was effective for the treatment of MR that emerged after mitral valve repair.
一名70岁男性因二尖瓣修复术后二尖瓣反流（MR）复发，伴有劳力性呼吸困难而转诊至我院。超声心动图显示主动脉下室间隔膨出，左心室流出道（LVOT）血流加速，二尖瓣收缩期前向运动伴中度MR，符合LVOT梗阻。由于药物治疗效果不佳，我们进行了经皮腔内室间隔心肌消融术（PTSMA）。术后，MR消失，LVOT压力梯度降低。患者症状改善。PTSMA对二尖瓣修复术后出现的MR治疗有效。
