心肺停止を来した重症僧帽弁狭窄症の1例

Critical Mitral Stenosis Presented with Cardiopulmonary Arrest

要旨　呼吸苦で救急搬送直後に心肺停止を来した僧帽弁狭窄症症例を経験した．リウマチ熱の既往があり20歳時に僧帽弁狭窄の指摘を受け以後2回手術適応と判断されていたが拒否していた．心肺蘇生に成功，遠隔期に手術(僧帽弁置換，三尖弁輪形成，左室ペーシング)を行い術後2年が経過した．現在リウマチ性弁膜症は少なくなっているが，手術適応となる症例は重症化，高齢化の傾向にあり手術にあたっては注意を要する．

　We report a case of critical mitral stenosis presented with a cardiopulmonary arrest soon after arriving at the hospital. She had history of rheumatic fever, and was diagnosed with mitral stenosis at 20 years of age. She was repeatedly advised to undergo valve surgery, but refused. Cardiopulmonary resuscitation was successful, and she underwent elective surgery including mitral valve replacement, tricuspid valve annuloplasty, and left ventricular pacing. Two years have passed since then, and she has been doing well. Currently, rheumatic valvular heart disease is rare, and surgeries need to be performed after considering the severity of the disease and age of the patients.