先天性大動脈二尖弁を伴った大動脈弁逸脱症に対する1手術治験例

A successful aortic valve replacement for the aortic valve prolapse with congenital bicuspid aortic valve

　今回，我々は38歳，男子において，先天性大動脈二尖弁・大動脈弁逸脱症による，大動脈弁閉鎖不全症（以下ARと略す。）に対して大動脈弁置換術を施行し，良好な結果を得た。大動脈弁逸脱症によるARは比較的まれな疾患であり，その成因・診断・外科的治療等につき若干の文献的考察を加え報告する。

We reported a successful aortic valve replacement for the thirty eight-year-old patient with aortic valve prolapse and congenitally bicuspid aortic valve.

In the congenitally bicuspid aortic valve, it is often observed that sclerosing or calcification of aortic valve make an aortic stenosis, infective endocarditis or rheumatic fever make an aortic regurgitation.

Aortic valve prolapse secondary to mucoid degene-ration for the bicuspid aortic valve has not been reported yet in the Japanese literature at this time.

Histopathological examination showed a mucoid degeneration changes in the exsected aortic valve. Mucoid degeneration is not a typical finding for the aortic valve prolapse or mitral valve prolapse, its degeneration is recognized in the rheumatic valvular desease, congenital heart disease and traumatic val-vular disease.

In the surgical treatment for aortic valve prolapse, valvoplasty is not sufficient because of occasional recurence, so we need a valve replacement.

Aortic valve replacement for this disease has a possibility of valve dehiscence like as MVR for mitral valve prolapse.

Then, several surgical techniques must be employed for the prevalence of valve dehisience.

Its techniques are as follows : interrupted suture, utilization of Teflon pledjet and subannular valve suture.