漏斗胸に大動脈弁閉鎖不全を合併した高齢者非Marfan症候群に対する一期的手術治療

One-stage Surgery for a Non-Marfan Elderly Patient with Aortic Regurgitation and Pectus Excavatum

漏斗胸に大動脈弁閉鎖不全（AR）を合併した高齢者に対して，胸骨形成術と大動脈弁置換術を一期的に行い，良好な結果を得たので報告する．

We describe a case of 1-stage surgery comprising aortic valve replacement and thoracoplasty that was performed on an elderly patient with a good result. An 85-year-old man visited our hospital with the chief complaint of chest discomfort. Examination revealed aortic regurgitation and pectus excavatum. Respiratory dysfunction, pulmonary hypertension, and cardiac failure were observed. We considered that pectus excavatum could affect breathing and circulation after surgery；therefore, we decided to perform a 1-stage surgery comprising aortic valve replacement and thoracoplasty. The costal cartilage and xiphoid process were resected, and median sternotomy was performed. The internal thoracic artery and vein were preserved. Aortic valve replacement was performed per the usual method. The resected costal cartilage was placed back at its site and the periosteum was sutured. The medially resected sternum was fixed and lifted with Kirschner wire. The patient recovered without any complication.