単孔式胸腔鏡補助下僧帽弁置換術

Uniportal Video-assisted Minimally Invasive Mitral Valve Replacement

心臓弁膜症に対して低侵襲心臓弁膜症手術を行うことが本邦において広まってきている．一方，低侵襲心臓弁膜症手術の方法に関してはいまだ改善の余地があると思われ，胸腔鏡補助下直視下心臓手術，完全鏡視下心臓手術，ロボット支援下心臓手術といったさまざまな方法が報告されている．われわれは僧帽弁閉鎖不全症に対して単孔式胸腔鏡補助下直視下僧帽弁置換術を行い良好な結果を得た症例を経験したので，若干の文献的考察を加味して報告する．

The feasibility of minimally invasive mitral valve surgery for treating degenerative mitral disease has been well established. Although surgery of this kind including robotic surgery usually needs multiple ports, uniportal surgery is a viable option, especially in cases with dense pleural adhesion. A 71-year-old woman complaining of dyspnea was admitted to the hospital. Transthoracic echocardiography revealed severe mitral regurgitation. Preoperative heart team decision was to perform mitral valve replacement （MVR） without mitral valve plasty （MVP） because the etiology was ventricular dysfunction. Accordingly, uniportal video-assisted minimally invasive MVR was performed, and uneventful outcome was obtained. Uniportal video-assisted minimally invasive mitral valve surgery may be a reasonable option.