Tabuchi A, Inada H, Masaki H, Morita I, Kanazawa S, Fujiwara T
Department of Surgery, Kawasaki Medical School, Okayama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Jun;44(6):869-73.
A 56-year-old female who was diagnosed incomplete endocardial cushion defect, underwent closure of ostium primum defect and repair of mitral cleft 2 years ago. Mitral and tricuspid ring annuloplasty was done 9 months after the first operation because of an increment of mitral and tricuspid valve regurgitation. The Third operation, mitral valve replacement by mechanical valve and tricuspid valve replacement by bioprosthetic valve, was performed because of the gradually increased mitral stenosis and tricuspid regurgitation. Post-operative course was uneventful. Resected anterior cusp of mitral and tricuspid valve revealed hypertrophy and shortness macroscopically, and revealed fibrosis and calcification histopathologically. It was considered that remarkable regurgitation was due to secondary change of both valves. We concluded that valve replacement should be performed for case of secondary change of atrioventricular valve in adult patient.
一名56岁女性,2年前被诊断为不完全性心内膜垫缺损,接受了原发孔缺损闭合及二尖瓣裂修补术。首次手术后9个月,因二尖瓣和三尖瓣反流增加,进行了二尖瓣和三尖瓣环成形术。第三次手术,因二尖瓣狭窄和三尖瓣反流逐渐加重,进行了二尖瓣机械瓣置换和三尖瓣生物瓣置换。术后过程顺利。切除的二尖瓣和三尖瓣前叶肉眼可见肥厚和缩短,组织病理学显示纤维化和钙化。认为明显的反流是由于两个瓣膜的继发性改变。我们得出结论,对于成年患者房室瓣继发性改变的情况应进行瓣膜置换。