大動脈弁狭窄症と左室流出路起源の心室期外収縮に対して手術を施行した1例

Aortic Valve Replacement Combined with Ablation for Outflow Tract Premature Ventricular Contraction：Report of a Case

はじめに　左室流出路起源の心室期外収縮（PVC）に対して外科的加療を施行した報告は比較的まれである．大動脈弁置換術（AVR）に併せてPVCに対する外科的アブレーションを施行した症例を経験したので報告する．

A 73-year-old woman suffered from premature ventricular contraction （PVC） which could not be controlled by medications. Holter 24-hour continuous recording electrocardiogram （Holter ECG） revealed 22,706 PVC beats/day. Upon further examination, she was found to have severe aortic stenosis and mild insufficiency. Preoperative electro-physiological study and standard 12-lead electrocardiogram revealed that the PVC originated from myocardium under the left coronary cusp. Aortic valve replacement and intraoperative cryoablation were performed. Her postoperative course was uneventful, Holter ECG revealed 638 PVC beats/day. Clinical symptons of PVC disappeared immediately after surgery. She was discharged 19 days after the operation.