静脈洞型心房中隔欠損症を伴う部分肺静脈還流異常症に対する右肋間小開胸アプローチでの修復

Minimally Invasive Cardiac Surgery for Partial Anomalous Pulmonary Venous Connection and Sinus Venosus Atrial Septal Defect

静脈洞型心房中隔欠損症を伴う部分肺静脈還流異常症による右心系拡大を認める若年男性に対して右肋間小開胸アプローチで心内修復術を行い，良好な結果を得たため報告する．

We report a successful case of minimally invasive cardiac surgery for partial anomalous pulmonary venous connection and sinus venosus atrial septal defect. A 45-year-old man had a severely enlarged right heart due to partial anomalous pulmonary venous connection and sinus venosus atrial septal defect, but no evidence of severe pulmonary hypertension was observed. Right third intercostal approach was used to incise the right atrium and the superior vena cava at the level of the partial anomalous pulmonary venous connection confluence so that the partial anomalous pulmonary venous connection orifice and the sinus venous atrial septal defect were well observed under endoscopic assistance. Intracardiac repair was performed by suturing a Gore-Tex patch with a continuous suture of 5-0 polypropylene thread through the two incision lines in the heart. Postoperative examination revealed no residual shunt or stenosis of the pulmonary vein or the superior vena cava, and the patient was discharged without complications.