Department of Cardiovascular Surgery, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan.
J Card Surg. 2022 Nov;37(11):3922-3924. doi: 10.1111/jocs.16898. Epub 2022 Sep 1.
A 77-year-old woman underwent mitral valve replacement and tricuspid annuloplasty for severe mitral stenosis and tricuspid regurgitation with pulmonary hypertension. Two months later, the patient was readmitted because of marked edema. A new harsh pansystolic murmur was auscultated, and echocardiography revealed a jet from the left ventricle to the right atrium but no paravalvular leakage was detected at the mitral valve position. At operation, an 6 mm defect adjacent to the tricuspid annulus in the interatrial septum and detachment of the anterior edge of the tricuspid ring were detected. The defect was closed using a pericardial patch. An inadequate stitch at the anteroseptal commissure in the previous operation led to left ventricular-right atrial communication.
一位 77 岁女性因严重二尖瓣狭窄和三尖瓣反流伴肺动脉高压而行二尖瓣置换和三尖瓣瓣环成形术。两个月后，因明显水肿再次入院。听诊新出现响亮全收缩期杂音，超声心动图示左心室至右心房射流，但二尖瓣位置未见瓣周漏。术中发现房间隔紧邻三尖瓣环处有一 6mm 缺损，三尖瓣环前缘分离。使用心包补片封闭缺损。既往手术前间隔结合部缝线不牢导致左心室-右心房交通。
