大動脈四尖弁に対して低侵襲大動脈弁置換術を施行した1例

Minimally Invasive Aortic Valve Replacement for Quadricuspid Aortic Valve：Report of a Case

はじめに　われわれは大動脈四尖弁を伴う大動脈弁狭窄症兼閉鎖不全症に対して生体弁（23 mm）による胸腔鏡下大動脈弁置換術［低侵襲心臓手術（MICS）-大動脈弁置換術（AVR）］を行った．AVRは右前胸部を小切開し，胸腔鏡下で行った．患者は術後経過良好で術後16日目に退院した．四尖弁はまれであり，さらにMICS-AVRを行った報告は非常に少ないため報告する．

A 80-year-old man presented to our hospital complaining exertional dyspnea. He was diagnosed with combined aortic valve regurgitation and stenosis due to quadricuspid aortic valve. The patient had no other cardiovascular anomaly. We performed aortic valve replacement （AVR） using minimally invasive cardiac surgery （MICS） approach. Four cusps were equal in size. Postoperative course was uneventful. AVR using MICS approach for quadricuspid aortic valve is extremely rare. In endoscopic surgery, the anatomical features of quadricuspid aortic valve can be more precisely understood, which may help in avoiding complications such as damage to the coronary ostia or the conduction system.