Kumano Hiroshi, Shuntoh Keisuke, Yamaguchi Akimitsu
Department of Cardiovascular Surgery, Northern Okinawa Cardiovascular Center, Nago, Japan.
Kyobu Geka. 2018 Mar;71(3):195-198.
A 72-year-old man was admitted to our hospital because of dyspnea. He had a history of cardiac resynchronization therapy for congestive heart failure due to dilated cardiomyopathy 6 months previously. Echocardiography revealed severe functional mitral regurgitation which had been mild 6 months before. Because medical treatment was ineffective, on-pump beating mitral valve replacement using a bioprosthesis was performed to prevent reperfusion injury. The patient was easily weaned from cardiopulmonary bypass with low-dose inotropic support and scheduled intra-aortic balloon pump. Then, he was discharged in a good condition on the 37th postoperative day. Beating mitral valve replacement seems to be a good surgical option for patients with poor left ventricular function.
一名72岁男性因呼吸困难入院。他6个月前因扩张型心肌病导致的充血性心力衰竭接受过心脏再同步治疗。超声心动图显示严重的功能性二尖瓣反流,而6个月前反流程度较轻。由于药物治疗无效,遂行体外循环心脏跳动中生物瓣二尖瓣置换术以预防再灌注损伤。患者在低剂量血管活性药物支持及预定的主动脉内球囊反搏辅助下很容易脱离体外循环。术后第37天,患者状况良好出院。对于左心室功能较差的患者,心脏跳动中二尖瓣置换术似乎是一种不错的手术选择。