人工弁脱落により3回目の手術を行った大動脈基部拡大を伴わない大動脈炎症候群の1例

The Third Operation for Prosthetic Valve Detachment Caused by Aortitis Syndrome without Aortic Ectasia；Report of a Case

はじめに　大動脈基部の拡大を認めないものの，度重なる人工弁脱落をきたした大動脈炎症候群に伴う大動脈閉鎖不全症（AR）の患者に対し，合計3回の手術の後良好な結果を得た症例を経験したので，手術法も含め報告する．

We report a surgical case of a 58-year-old woman with aortitis syndrome is presented. The patient had undergone aortic valve replacement （AVR） with a mechanical prosthesis. Five months later, re-AVR was performed because of prosthetic valve detachment and severe regurgitation. Five years after the re-operation, valve detachment with severe perivalvular leakage was noted again. The 3rd AVR was performed with a biological prosthesis. This time, the prosthetic valve was fixed by 2-0 Ticron sutures buttressed with a felt strip from outside of the aorta at the site of detachment. Administration of prednisolone has been continued for 16 years since the 1st operation. No valve detachment has been noted for 8 years since the 3rd operation.