急速，広範な腱索断裂のため緊急手術を行った僧帽弁逸脱症候群の1治験例

A Case Report on Mitral Valve Prolapse Syndrome with Rapid and Extensive Rupture of the Chordae Tendineae of the Mitral Valve

　僧帽弁逸脱症候群mitral valve prolapse syndrome（MVP）はfloppy valve syndrome^1），billowing mitral　valve leaflet^2）などとも呼ばれ，いまだに病因に不明な点の多い症候群である。一般にMVPの予後は比較的良好であるとされているが^3〜5），不整脈や胸痛に加えて，経年的な僧帽弁逆流^8〜10）（MR）の進行，腱索断裂^11〜14）や細菌性心内膜炎^{10,13〜16）}の合併のため手術を必要とする症例も比較的多く^11,14,17），外科的にも解明が急がれている。

　われわれは最近急速かつ広範な腱索断裂のため心不全に陥った僧帽弁粘液変性に基づくMVPの1症例に緊急人工弁置換術を行い救命したので報告し併せてMVPについて外科的な立場から検討を加え報告する。

A 46-year-old male was admitted to Kobe Municipal Central Hospital on March 16, 1979, because he suffered from mitral insufficiency ascribed to a rapid and extensive rupture of the chordae tendineae. Hours after admission, the operation of mitral replacement with porcine prosthesis was performed and the good result was obtained.

The patient had the history of hospitalization due to pneumonia in Shinko Hospital on February 24, 1979. During the hospital days, he received the diagnosis as a slight rupure of the chordae tendineae of the mitral valve and as mitral valve prolapse syndrome. The symptom of mitral in-sufficiency was allowed to remain on account of the slight. However, simultaneously with severe cough, very severe mitral insufficiency developed suddenly. Subsequently, the patient suffered from acute cardiac failure and was transfered to the above-mentioned Kobe Municipal Central Hospital.