Maze手術が奏効した早期心房性機能性僧帽弁閉鎖不全の1例

Valve Plasty and Concomitant Maze Procedure for Early Stage Atrial Functional Mitral Regurgitation：Report of a Case

はじめに　2020年に『弁膜症治療のガイドライン』が改訂され，新たに心房性機能性僧帽弁閉鎖不全症が追加された1）．その特徴は，心室性機能性僧帽弁閉鎖不全症の原因となるような左室異常がなく，弁尖や腱索に器質的異常が乏しいにもかかわらず生じている僧帽弁閉鎖不全症（MR）で，左房拡大を認め，そのほとんどに心房細動を伴っているという．

We report a case of atrial functional mitral regurgitation in a 42-year-old man with chronic atrial fibrillation. His medical history included cerebral infarction. Transthoracic echocardiography revealed moderate mitral regurgitation and mild triculpid valve regurgitation due to annular dilatation with atrial enlargement and tethering of the posterior mitral leaflet. Mitral valve repair and tricuspid annuloplasty, maze procedure were performed via median sternotomy. Mitral valve repair was performed by ring annuloplasty and edge to edge repair at posterior commissure. Mitral and tricupid regurgitation were well controlled in postoperative echocardiography and electrocardiogram showed sinus rhythm.