Key result
Surgical repair combining tricuspid annuloplasty with subvalvular and leaflet techniques successfully treated severe tricuspid regurgitation caused by a congenital right-sided pericardial defect.
Why the study?
Pericardial defects are rare congenital anomalies that are difficult to diagnose and often found incidentally during thoracic surgery.
Case Report (n=1)
No
Severe tricuspid regurgitation caused by right atrial dilatation due to a congenital right-sided pericardial defect can be successfully treated with complex tricuspid valve repair including subvalvular techniques.
Incidental pericardial defect found during TR repair surgery; leaves open whether targeted preoperative imaging improves outcomes in right heart failure.
心膜欠損症は稀な先天性疾患で，その診断は必ずしも容易ではない．無症状で経過し，他疾患に対する胸部手術の際に偶然発見される症例も多い．今回われわれは，重症三尖弁閉鎖不全症に対する開心術時に右側心膜欠損症合併が判明した1例を経験したので報告する．症例は79歳，男性．12年前に持続性心房細動の診断で抗凝固療法が開始された．2年前より労作時息切れおよび両側下腿浮腫が出現し，利尿剤内服が開始されるも増悪傾向であり，精査加療目的で当院紹介となった．精査の結果，著明な右心系の拡大に伴う重症三尖弁閉鎖不全症，中等症僧帽弁閉鎖不全症，永続性心房細動による心不全の診断となった．手術は三尖弁形成術 (Physio Tricuspid Annuloplasty Ring 28 mm＋right ventricular papillary muscle approximation＋anterior-septal commissure plication＋neochordae reconstruction) ＋僧帽弁形成術 (Physio II Annuloplasty Ring 34 mm) ＋左心耳切除術を施行した．術中に右側心膜の広範な欠損を認め，右房は心膜欠損孔を経由し右胸腔内へ伸展していた．右側心膜欠損症を合併していたために右房の拡大を妨げる構造物がなく，著明に拡大した結果，重症三尖弁閉鎖不全症を引き起こしたと推察された．
No takes yet. Share an insight, caveat, or question.
Yokota et al. (2023) conducted a case report in Severe tricuspid regurgitation associated with congenital right-sided defect of the pericardium (n=1). Tricuspid valve repair (annuloplasty, right ventricular papillary muscle approximation, commissure plication, and neochordae reconstruction) was evaluated on Surgical success and postoperative NYHA functional class. Surgical repair combining tricuspid annuloplasty with subvalvular and leaflet techniques successfully treated severe tricuspid regurgitation caused by a congenital right-sided pericardial defect.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: