Yajima Shin, Fukushima Satsuki, Kakuta Takashi, Fujita Tomoyuki
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1, Fujishirodai, Suita, Osaka 565-8565, Japan.
Eur Heart J Case Rep. 2020 Feb 7;4(1):1-6. doi: 10.1093/ehjcr/ytz240. eCollection 2020 Feb.
Rheumatic mitral valve (MV) disease is the major cause of congestive cardiac failure in children and young adults, particularly in developing countries. Mitral valve repair with minimum prosthetic material is the gold standard treatment for this condition. However, MV repair for rheumatic MV disease is known to be technically demanding.
A 27-year-old woman without a history of cardiac disease presented with dyspnoea on exertion. Echocardiography revealed rheumatic severe mitral stenosis and regurgitation, with thickening of the bileaflets, doming of the anterior leaflet, shortening of the posterior leaflet, fusions of the lateral and particularly the medial commissure, and enlargement of the mitral annulus. We successfully performed robot-assisted MV repair with bicommissural release, patch augmentation of the two leaflets, and implantation of an originally sized partial band.
Robotic MV repair can contribute to precise valve inspection and operative procedures. This approach seems feasible for complex rheumatic MV disease particularly in young patients.
风湿性二尖瓣疾病是儿童和青年人心力衰竭的主要原因，在发展中国家尤为如此。使用最少人工材料进行二尖瓣修复是这种疾病的金标准治疗方法。然而，已知风湿性二尖瓣疾病的二尖瓣修复技术要求很高。
一名27岁无心脏病史的女性出现劳力性呼吸困难。超声心动图显示风湿性重度二尖瓣狭窄和反流，瓣叶增厚，前叶圆顶状，后叶缩短，外侧尤其是内侧瓣叶融合，二尖瓣环扩大。我们成功地进行了机器人辅助二尖瓣修复，包括双瓣叶交界松解、双瓣叶补片扩大和植入原尺寸的部分带环。
机器人二尖瓣修复有助于精确的瓣膜检查和手术操作。这种方法对于复杂的风湿性二尖瓣疾病似乎是可行的，特别是在年轻患者中。
