左肺切除後の高度縦隔左方偏位に対し僧帽弁および三尖弁手術を施行した1例

Concurrent Mitral and Tricuspid Valve Surgery in a Patient with Left Collapsed Lung；Report of a Case

はじめに　われわれは，結核による左肺虚脱および高度な縦隔左方偏位をきたした症例に対し，僧帽弁置換術および三尖弁輪縫縮術を施行した．解剖学的異常や呼吸機能低下といった問題点があったが，良好な経過が得られたため文献的考察を加えて報告する．

A 77-year-old man was referred to our hospital with severe mitral valve regurgitation. Secondary to left partial lobectomy for tuberculosis 55 years earlier, his mediastinum was shifted to the left, and his pulmonary function was moderately decreased. Mitral valve replacement and tricuspid annuloplasty were performed with a median sternotomy. Although the heart was shifted to the left, the mitral valve was easily visualized when the right side of the pericardium was extensively elevated. The tracheal intubation tube was removed 1 day after the operation. The patient’s postoperative course was uneventful, and he was discharged on the 13th postoperative day. We describe our surgical strategy in this patient with a literature review.