術前検査で右房腫瘍と診断された三尖弁瘤の1例

Tricuspid Valve Aneurysm Preoperatively Diagnosed with Right Atrial Tumor；Report of a Case

はじめに　弁瘤は比較的まれな疾患であり，さまざまな原因で発生することが知られているが，心臓腫瘍や感染性心内膜炎（infective endocarditis：IE）に伴う疣贅との鑑別が困難となることがある．われわれは，術前に右房内可動性腫瘍と診断されたが，手術所見および病理組織所見より三尖弁瘤の診断となった1例を経験したため報告する．

A 79-year-old woman visited a hospital with coronary vasospastic angina and supraventricular tachycardia. Periodic inspection of echocardiography suggested a right atrial tumor which was not pointed out 6 months ago, but magnetic resonance imaging suggested a valve aneurysm. These findings were contradictory. We preoperatively diagnosed a cardiac tumor because of its new onset and mobility. Tumor resection and valve repair was planned in consideration of the risk of embolism. As a result, we finally diagnosed tricuspid valve aneurysm from the intraoperative findings and histopathological findings. We assumed that valve aneurysm was formed in the healing process of subclinical infective endocarditis. It was inferred that preoperative diagnosis of valve aneurysm is very difficult.