心房中隔欠損孔辺縁に茎をもつ左房粘液腫に対する完全内視鏡下手術の1例

Totally Endoscopic Surgery for the Left Atrial Myxoma and the Atrial Septal Defect：Report of a Case

はじめに　心臓腫瘍の発生頻度は0.002～0.3％とまれである．そのうち約60％が良性腫瘍であり，その中で粘液腫が約30～50％ともっとも多い1，2）．また，先天性心疾患の発生頻度は約1％であり，心房中隔欠損症（ASD）は先天性心疾患全体の8～10％を占める3）．心臓粘液腫にASDを合併することはまれである．

A 60-year-old woman was admitted to our institution for exertional dyspnea. Transthoracic echocardiography revealed a 1.6 cm secundum atrial septal defect （ASD） and a 4.2×3.1 cm mobile left atrial mass originating from the ASD. The tumor migrated to the mitral valve during diastole and to the atrial septal defect during systole. A totally endoscopic approach via a small right thoracotomy was adopted to resect the mass and close the ASD with a Hemashield patch. Histopathologic examination of the excised mass was consistent with myxoma. The postoperative course was uneventful. A 2-year follow-up revealed no recurrence of the myxoma and ASD.