Key result
Aortic valve repair using fixation sutures through the right atrium and interventricular septum successfully resolved perivalvular leakage in a fragile aortic annulus without recurrence over 9 months.
Case Report (n=1)
No
Aortic valve fixation sutures through the right atrium and inter-ventricular septum may be a useful alternative for repairing perivalvular leakage in a fragile aortic annulus after prosthetic valve endocarditis.
May offer an alternative for perivalvular leak repair in fragile annuli; hypothesis-generating and requires prospective validation.
人工弁心内膜炎に対する大動脈弁再置換術後に弁周囲逆流を認め，修復術を施行して良好な結果を得た1例を報告する．症例は77歳男性．大動脈弁狭窄症に対し大動脈弁置換術（Carpentier Edwards Pericardial Magna 19 mm）を施行した．6カ月後に微熱と心不全徴候が出現し，心臓超音波検査で左冠尖-無冠尖間の弁周囲逆流を認め，血液培養からMethicillin-resistant Staphylococcus aureusを検出し，人工弁感染性心内膜炎と診断し大動脈弁置換術（Mosaic 21 mm）を施行した．その6カ月後に経食道心臓超音波検査で前回と対側の右冠尖-無冠尖間で弁周囲逆流と人工弁弁座動揺を認め，経右心房・経心室中隔から人工弁弁輪を固定し修復術を施行した．術後，心臓超音波検査で弁周囲逆流は認められなかった．本症例では，再置換術後の感染のない脆弱化した弁輪組織に対して，安定した組織のある大動脈外側からの修復術が有用であると考えられた．
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Fujii et al. (2012) conducted a case report in Aortic valve periprosthetic leakage (n=1). Aortic valve repair via right atrium and interventricular septum was evaluated on Resolution of perivalvular leakage. Aortic valve repair using fixation sutures through the right atrium and interventricular septum successfully resolved perivalvular leakage in a fragile aortic annulus without recurrence over 9 months.
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