Mizukami Shoichiro, Ise Hayato, Nakanishi Sentaro, Ishikawa Natsuya, Kamiya Hiroyuki
Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.
Kyobu Geka. 2018 Dec;71(13):1109-1113.
A 79-year-old woman visited a hospital with coronary vasospastic angina and supraventricular tachycardia. Periodic inspection of echocardiography suggested a right atrial tumor which was not pointed out 6 months ago, but magnetic resonance imaging suggested a valve aneurysm. These findings were contradictory. We preoperatively diagnosed a cardiac tumor because of its new onset and mobility. Tumor resection and valve repair was planned in consideration of the risk of embolism. As a result, we finally diagnosed tricuspid valve aneurysm from the intraoperative findings and histopathological findings. We assumed that valve aneurysm was formed in the healing process of subclinical infective endocarditis. It was inferred that preoperative diagnosis of valve aneurysm is very difficult.
一名79岁女性因冠状动脉痉挛性心绞痛和室上性心动过速前往医院就诊。超声心动图定期检查提示右心房肿瘤，而6个月前并未发现该肿瘤，但磁共振成像提示瓣膜瘤。这些检查结果相互矛盾。鉴于该肿瘤为新发且具有可移动性，我们术前诊断为心脏肿瘤。考虑到栓塞风险，计划进行肿瘤切除和瓣膜修复。结果，根据术中发现和组织病理学检查结果，我们最终诊断为三尖瓣瘤。我们推测瓣膜瘤是在亚临床感染性心内膜炎的愈合过程中形成的。据推断，瓣膜瘤的术前诊断非常困难。
