多発性骨髄腫合併例に対する低侵襲大動脈弁置換術の1例

Aortic Valve Replacement Using Minimally Invasive Cardiac Surgery Procedure in a Patient with Multiple Myeloma：Report of a Case

はじめに　多発性骨髄腫（multiple myelo­­ma：MM）は予後不良の疾患で，本疾患を合併した心・大血管手術はその報告例が少なく1～4），凝固障害に伴う出血傾向，血液粘稠度の変化，免疫抑制による易感染性，骨髄不全など周術期にさまざまな合併症を生じる可能性が指摘されている1）．近年，低侵襲心臓手術（minimally invasive cardiac surgery：MICS）の広まりで胸骨切開を回避する方法も選択肢の一つとなった．

Multiple myeloma （MM） is a disease with a poor prognosis, and there are few reports of cardiac surgery complicated by this disease, which can lead to various perioperative complications such as bleeding tendency due to coagulation defects, changes in blood viscosity, immunocompromise, and bone marrow insufficiency when undergoing cardiac surgery. In recent years, with the spread of minimally invasive cardiac surgery （MICS）, avoidance of sternotomy has become an option. We present a case of a 70-year-old man who underwent aortic valve replacement using MICS procedure for aortic regurgitation complicated with MM.