巨大右房粘液腫摘出後に三尖弁輪形成術を要した1例

Concomitant Tricuspid Annuloplasty with Resection of a Giant Right Atrial Myxoma：Report of a Case

はじめに　原発性心臓腫瘍は非常にまれな疾患であり（全人口の0.02〜2.8％），その中のおよそ40％を粘液腫が占めている．左房由来が70％ほどで，右房粘液腫は10％程度と，さらにまれとされている1）．また腫瘍摘出に加え，弁形成術などの追加処置が必要になることは少ない2）．われわれは右房粘液腫摘出後に三尖弁形成術を行った症例を経験したので報告する．

Myxomas account for the vast majority of heart tumors in adults. About 70％ originate in the left atrium, while about 10％ of these are reported to originate in the right atrium. A 70-year-old man with dyspnea, was found to have a giant right atrial mass by echocardiography, and tumor resection was performed under cardiopulmonary bypass （CPB） through a median sternotomy. At weaning from CPB the patient was hemodynamically unstable. Intraoperative echocardiography showed severe tricuspid regurgitation （TR）, and tricuspid annuloplasty was performed. The postoperative course was uneventful and histopathological examination confirmed that the tumor was a myxoma. It is important to keep in mind that regurgitation of the atrio-ventricular valve might occur after resection of atrial myxoma.