Key result
Complete resection of a tricuspid valve myxoma and subsequent valve repair with artificial chordae successfully controlled tricuspid regurgitation with no tumor recurrence at 6 months.
Case Report (n=1)
No
This case demonstrates that tricuspid valve repair using artificial chordae and annuloplasty is a feasible and effective surgical strategy following the resection of a rare tricuspid valve myxoma involving the chordae and papillary muscle.
Adds to sparse reports on tricuspid myxoma repair; leaves open long-term outcomes and optimal techniques.
症例は76歳女性．胃ポリープに対して内視鏡的切除後，消化器内科外来へ通院中，腹部超音波検査で偶然に心臓腫瘍を指摘され当科へ紹介となった．精査の結果，右室流出路に茎を持ち可動性に富む34×25 mm大の腫瘍を認め，粘液腫が疑われた．収縮期に腫瘍は肺動脈弁を越えており，塞栓症や嵌頓の危険性が高いと判断し，翌日準緊急手術を行う方針とした．手術は人工心肺下に施行した．大動脈遮断後肺動脈本幹を縦切開し右室流出路まで延長したところ，肺動脈弁直下に腫瘍を確認できた．腫瘍の茎は三尖弁前尖の腱索および乳頭筋付着部から連続していたため，一部合併切除する形で腫瘍を摘出し，断端に腫瘍の遺残がないことを確認した．さらに右房を切開し観察すると，三尖弁逆流を認めたため，前尖腱索を人工腱索により再建したのち弁輪縫縮を追加し逆流の消失を確認，手術を終了した．術後特記すべき合併症は認めず良好に経過し，術後13日目に退院となった．
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Shibamoto et al. (2011) conducted a case report in Tricuspid valve myxoma (n=1). Tumor resection and tricuspid valve repair with artificial chordae was evaluated on Postoperative tricuspid regurgitation and tumor recurrence. Complete resection of a tricuspid valve myxoma and subsequent valve repair with artificial chordae successfully controlled tricuspid regurgitation with no tumor recurrence at 6 months.
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