成人期に指摘された右室二腔症の1例

Two-chambered Right Ventricle Diagnosed in Adulthood：Report of a Case

はじめに　右室二腔症は，異常筋束により右室に流入路側高圧腔と流出路側低圧腔の二つの腔を形成する疾患であり，多くは幼少期～青年期に指摘される1）．われわれは，成人期に指摘された右室二腔症に対して異常筋束切除と右室流出路パッチ拡大術を行った症例を経験したので，若干の文献的考察を加えて報告する．

A 64-year-old female without symptoms of heart failure was diagnosed with a two-chambered right ventricle （TCRV） during examination of a heart murmur and cardiac enlargement, for which surgery was performed. Under cardiopulmonary bypass and cardiac arrest, we first performed a right atrium and pulmonary artery incision and observed the right ventricle through the tricuspid and pulmonary valves, although we could not obtain a sufficient view of the right ventricular outflow tract. After subsequently incising the right ventricular outflow tract and the anomalous muscle bundle, the right ventricular outflow tract was patch-enlarged using a bovine cardiovascular membrane. After weaning from cardiopulmonary bypass, disappearance of the pressure gradient in the right ventricular outflow tract was confirmed. The patient’s postoperative course was uneventful without any complications including arrhythmia.