Kishigami Takehiro, Ikushima Eigo, Yasutsune Toru, Nishimura Yosuke
Department of Cardiovascular Surgery, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2019;41(2):239-242. doi: 10.7888/juoeh.41.239.
We report a case of a 55-year-old male who had been diagnosed with mitral regurgitation and atrial septal defect 5 years earlier. He was referred to our institution because of worsening of mitral regurgitation accompanied by exertional dyspnea. As an echocardiography showed atrioventricular valve regurgitation and ostium primum atrial septal defect, but without ventricular septal defect, he was diagnosed as having partial atrioventricular septal defect (pAVSD). An operation was performed through median sternotomy. The anterior atrioventricular leaflet had a cleft and thickening with calcification. Suturing the cleft could not control the regurgitation. Incomplete coaptation was seen at the edge of the anastomosis site of the cleft, where the severe calcification had been identified. A rough zone including a part of the chordae tendineae was sutured in order to compensate for the gap. The atrioventricular septal defect was closed with an autologous pericardial patch. He was discharged uneventfully on the 24th postoperative day and has been followed up without complications for 1.5 years.
我们报告一例55岁男性患者,其于5年前被诊断为二尖瓣反流和房间隔缺损。因二尖瓣反流加重并伴有劳力性呼吸困难,他被转诊至我院。经超声心动图检查显示房室瓣反流和原发孔房间隔缺损,但无室间隔缺损,故诊断为部分房室间隔缺损(pAVSD)。通过正中胸骨切开术进行了手术。前房室瓣叶有一个裂口,增厚并伴有钙化。缝合裂口无法控制反流。在裂口吻合边缘处可见不完全对合,此处已发现严重钙化。为弥补间隙,对包括部分腱索在内的一个粗糙区域进行了缝合。用自体心包补片封闭房室间隔缺损。患者术后第24天顺利出院,随访1.5年无并发症。