自然閉鎖した心室中隔欠損の1剖検例

Spontaneous Closure of Ventricular Septal Defect:A case report

緒言

　心室中隔欠損症のnatural historyとして自然閉鎖が確かにあることは，欧米ではFrench, Weber （1918）^14）の報告があり，1950年以後には多くの報告例をみる^1）〜13）。しかし本邦では文献上その報告例をみない。われわれは最近心房中隔欠損と僧帽弁閉鎖不全を伴う症例に根治手術を行なったが，不幸にも死の転帰をとり，剖検により自然閉鎖した心室中隔欠損を確認したので報告する。

Spontaneous closure of the ventricular septal defect was demonstrated in a patient on the basis of anatomical finding. Not so many cases of anatomically proved spontane-ous closure have been reported yet in abroad, and no such report was in Japan.

The patient was a 9 year old girl whose preoperative diagnosis was atrial septal de-fect with mitral insufficiency. Open heart surgery was performed for correction of the above mentioned lesions. The patient died after the operation. At autopsy, there was an evidence that there was a defect (8 mm in diameter) located at the membraneous portion of the ventricular septum and this was completely closed afterward by the septal leaflet of tricuspidal valve.

The mitral insufficiency in this case was codsidered to be congenital because of no history of suffering from endocarditis and of no histological sequelae of rheumatic or bacterial endocarditis.