完全房室中隔欠損術後に左側房室弁置換術および右側房室弁尖延長術を施行した1例

Replacement of Left Atrioventricular Valve and Patch Augmentation of Right Atrioventricular Valve After Repair of Complete Atrioventricular Septal Defect：Report of a Case

はじめに　完全房室中隔欠損症（cAVSD）の手術死亡率は改善しているが，再手術リスクは依然として高く，患者の生活の質（QOL）に影響を与える1）．われわれはcAVSD術後の両側房室弁閉鎖不全に対して左側房室弁置換術と右側房弁尖延長術を実施し，良好な結果を得たので報告する．

Reoperations can be challenging for patients who experience left and right atrioventricular valve failure after repair of a complete atrioventricular septal defect. Herein, we present a case of a 10-year-old boy who developed dysfunction in left and right atrioventricular valve following surgery for a complete atrioventricular septal defect. The patient underwent successful replacement of his left atrioventricular valve with a mechanical valve due to severe stenosis. Additionally, his right atrioventricular valve, in which the bridging leaflets adhered to the ventricular septal defect patch, causing the significant regurgitation, was repaired. The bridging leaflets were augmented using the autologous pericardium treated with ethanol after detaching the leaflets and chordae from the patch. Postoperative echocardiography showed that the prosthetic valve was functioning well, with no significant regurgitation in the right atrioventricular valve. This technique could benefit patients experiencing complex valve failures following atrioventricular septal defect surgery.