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The Japanese Journal of Thoracic Surgery Volume 71, Issue 3 （March 2018）

胸部外科 71巻3号（2018年3月発行）

Japanese English

症例

心臓再同期療法後の機能的僧帽弁逆流に対する心拍動下僧帽弁置換術の1例 Beating Mitral Valve Replacement for Functional Mitral Regurgitation after Cardiac Resynchronization Therapy；Report of a Case 熊野浩 ¹ , 春藤啓介 ¹ , 山口明満 ¹ Hiroshi Kumano ¹ , Keisuke Shuntoh ¹ , Akimitsu Yamaguchi ¹ ¹北部地区医師会附属病院心臓血管センター心臓血管外科 ¹Department of Cardiovascular Surgery, Northern Okinawa Cardiovascular Center キーワード：心臓再同期療法 , 機能的僧帽弁逆流 , 心拍動下僧帽弁置換術 Keyword: cardiac resynchronization therapy , functional mitral regurgitation , beating mitral valve replacement pp.195-198

発行日 2018年3月1日 Published Date 2018/3/1

DOI https://doi.org/10.15106/j_kyobu71_195

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Abstract 文献概要
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参考文献 Reference

心臓再同期療法（cardiac resynchronization therapy：CRT）は重症心不全例に対する有効な治療法と報告1）されて以来，拡張型心筋症（dilated cardiomyopathy：DCM）などの治療に効果をあげている．しかしながら，DCMに対して除細動機能付きCRT（CRT defibrillator：CRT-D）を行っても機能的僧帽弁逆流（function

A 72-year-old man was admitted to our hospital because of dyspnea. He had a history of cardiac resynchronization therapy for congestive heart failure due to dilated cardiomyopathy 6 months previously. Echocardiography revealed severe functional mitral regurgitation which had been mild 6 months before. Because medical treatment was ineffective, on-pump beating mitral valve replacement using a bioprosthesis was performed to prevent reperfusion injury. The patient was easily weaned from cardiopulmonary bypass with low-dose inotropic support and scheduled intra-aortic balloon pump. Then, he was discharged in a good condition on the 37th postoperative day. Beating mitral valve replacement seems to be a good surgical option for patients with poor left ventricular function.