左右巨大心房による呼吸障害に対する心房縫縮

Successful Atrial Plication in Improving Respiratory Failure due to Bilateral Giant Atria

巨大心房は呼吸障害を呈することがある1）．われわれは，リウマチ性弁膜症術後の両側の巨大心房による呼吸障害と三尖弁閉鎖不全症（TR）を認めた症例に対し，弁形成術とともに心房縫縮術を施行し良好な結果を得たので報告する．

Giant atria may trigger respiratory failure, which often requires surgical intervention. We report a patient who presented with respiratory failure due to bilateral giant atria. The patient was a 75-year-old woman with rheumatic heart disease. She had undergone mitral valve replacement and tricuspid annuloplasty at another hospital 17 years ago but recently developed respiratory dysfunction. Compression to the lungs by enlarged atria was diagnosed as the main cause of respiratory dysfunction. Hence, the anterior-to-posterior left atrial wall was plicated by para-annular and superior-half plication, respectively, and the right atrial wall was excised into an ellipse shape. Tricuspid valvuloplasty was performed on four sets of eight artificial chordae with CV5 sutures and an annuloplasty ring. Respiratory failure was alleviated after the surgery.