Inagaki Masahiro, Koyama Yutaka, Sawada Koushi, Okawa Yasuhide
Department of Cardiovascular Surgery, Gifu Heart Center, Gifu, Japan.
Kyobu Geka. 2022 Mar;75(3):185-188.
Fenestration of the aortic valve cusps rarely causes aortic regurgitation. A 54-year-old woman was diagnosed with aortic regurgitation secondary to a ruptured fibrous strand in a fenestrated aortic valve cusp. Diastolic murmur was pointed out during health checkup five months earlier, and transthoracic echocardiography revealed severe aortic valve regurgitation with a mobile mass attached to the aortic valve cusp. The patient underwent aortic valve replacement. Intraoperatively, we observed a ruptured fibrous strand attached to the non-coronary cusp and cusp laceration, both of which caused severe aortic regurgitation. Histopathological examination of the resected specimen showed myxomatous degeneration. The patient's postoperative course was uneventful, and she was discharged in a stable condition on postoperative day 14.
主动脉瓣叶开窗术很少引起主动脉瓣关闭不全。一名54岁女性被诊断为因开窗的主动脉瓣叶上的纤维束破裂继发主动脉瓣关闭不全。五个月前健康检查时发现舒张期杂音，经胸超声心动图显示严重的主动脉瓣反流，主动脉瓣叶上附着有活动团块。患者接受了主动脉瓣置换术。术中，我们观察到附着于无冠瓣叶的纤维束破裂和瓣叶撕裂，二者均导致严重的主动脉瓣反流。切除标本的组织病理学检查显示黏液样变性。患者术后恢复顺利，术后第14天病情稳定出院。
