Kuwano Akito, Yoshikai Masaru, Satoh Hisashi
Department of Cardiovascular Surgery, Shin Koga Hospital, Kurume, Japan.
Kyobu Geka. 2023 Jun;76(6):450-453.
A 73-year-old woman with a history of aortitis syndrome was referred to our hospital presenting with congestive heart failure caused by acute severe mitral regurgitation due to posterior leaflet prolapse. Upon admission, the patient fell into shock state while undergoing an examination. Medical treatment including mechanical ventilation could not alleviate circulatory collapse, so emergency surgery was performed on the day of admission. Severe calcification of the ascending aorta and severe stenosis or occlusion of the aortic arch vessels resulted from the patient's aortitis syndrome precluded aortic cannulation and aortic clamp. Therefore, mitral valve repair was performed under ventricular fibrillation at moderate hypothermia. Surgery was successful, and the patient recovered well without any cerebral complications after the surgery.
一名73岁患有大动脉炎综合征的女性因后叶脱垂导致急性重度二尖瓣反流，进而引发充血性心力衰竭，被转诊至我院。入院时，患者在接受检查时陷入休克状态。包括机械通气在内的药物治疗无法缓解循环衰竭，因此在入院当天进行了急诊手术。患者的大动脉炎综合征导致升主动脉严重钙化以及主动脉弓血管严重狭窄或闭塞，无法进行主动脉插管和主动脉钳夹。因此，在中度低温心室颤动下进行了二尖瓣修复术。手术成功，患者术后恢复良好，未出现任何脑部并发症。
