5. 再僧帽弁形成術

Repeat Mitral Valve Repair

再弁形成術では高い完成度が要求されるため，外科医にとってハードルの高い手術の一つになっている．本稿では，逸脱に対する弁形成術後の「再逆流」に限定して，その原因，手術のタイミング，形成手技などを解説する．

The keys to successful repeat mitral valve repair are careful selection of eligible patients and the use of high-quality surgical techniques. Regarding patient selection, patients with soft leaflet tissue, redundant rough-zone areas, and posterior mitral leaflet regions are good candidates for repeat repair. Autologous pericardial patch reinforcement for sutured dehiscence line, triangular resection for residual excess tissue, and sophisticated neo-chord reconstruction are high-quality techniques that increase the durability of repeat repair．