ウシ心囊弁を使用した僧帽弁置換術中にカフリークを認めた1例

Transprosthetic Cuff Leakage of the MITRIS RESILIA Mitral Valve During Mitral Valve Replacement：Report of a Case

はじめに　弁置換術中の経食道心エコー（TEE）で認める逆流は，経弁逆流（TVL）であるか弁周囲逆流（PVL）であるかの鑑別が重要である．しかし近年，両者に分類しがたいtransprosthetic leak（TPL）の報告がある．われわれは，僧帽弁置換術（MVR）中にマイトリスRESILIA生体弁（Edwards Lifesciences社，Irvine）では初となるTPLを認めた症例を経験したので報告する．

An 82-year-old woman was referred to our hospital because of severe mitral valve regurgitation （MR） with symptoms of heart failure. Preoperative transesophageal echocardiography （TEE） showed P2 prolapse due to chordal rupture, severe calcification of P2, and mild tricuspid valve regurgitation. The patient underwent mitral valve replacement using the MITRIS RESILIA mitral valve and tricuspid annuloplasty. Intraoperative TEE showed a mild regurgitation from the cuff on the A1P1 side at the mitral valve position. After the second aortic declamping, 4-0 prolene felted mattress suture was placed on the needle hole in the cuff. In repeat TEE, regurgitation improved to trace. Postoperative echocardiography confirmed disappearance of transprosthetic cuff leakage at the mitral valve, and the patient was discharged on postoperative day 36. We experienced a transprothetic cuff leakage, which is the first case on the MITRIS RESILIA mitral valve.