修正大血管転位の三尖弁閉鎖不全に対する弁置換術

Valve Replacement for Tricuspid Regurgitation with Congenitally Corrected Transposition of the Great Arteries

修正大血管転位（cTGA）は，先天性心疾患の1％未満とまれな疾患である．解剖学的右室が体循環の左室として機能するため，三尖弁閉鎖不全（TR）による心不全の合併や，刺激伝導系の走行異常による房室ブロックが長期予後に関係するといわれている．われわれは成人cTGAのTRに対し，三尖弁置換術（TVR）を施行した症例を経験したので報告する．

Congenitally corrected transposition of the great arteries accounts for less than 1％ of congenital heart diseases, and is defined as ventriculoarterial and atrioventricular discordance. We report a case of a 56-year-old woman complaining of persistent cough, who was diagnosed with congenitally corrected transposition of the great arteries and dextrocardia. Moderate regurgitation of the systemic tricuspid valve was revealed. The surgeon was positioned on the left side of the patient, and performed tricuspid valve replacement through the left atrium. Furthermore, mitral valve annuloplasty, atrial septal defect closure, and myocardial electrode implantation were performed. The postoperative course was uneventful.