72-year-old woman with severe aortic stenosis and severe mitral stenosis complicated by severe mitral annulus calcification, with a history of dialysis, diabetes, and arteriosclerosis obliterans (n=1).
Mitral valve replacement using the chimney technique and aortic valve replacement.
Valve function and paravalvular leakage at 14 months postoperatively.
Chimney mitral valve replacement appears to be a safe and useful surgical option for patients with mitral stenosis and severe mitral annular calcification, avoiding the risks of calcification resection.
症例は既往に透析，糖尿病，閉塞性動脈硬化症がある72歳女性．経胸壁心エコーで重症大動脈弁狭窄症および重症僧帽弁狭窄症を認めた．僧帽弁は両尖ともに石灰化し，可動性が低下していた．また後尖から後交連にかけて著明な弁輪の石灰化を認めた．石灰化を切除することでの致命的な合併症を懸念し，chimney techniqueを用いた僧帽弁置換術および大動脈弁置換術を行った．術後14カ月が経過するが弁の動きに問題なく弁周囲逆流も認めなかった．今回施行したchimney MVRは重度の僧帽弁輪石灰化を伴う僧帽弁狭窄症に対し安全で有用な方法と考えられた．
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Arakaki et al. (Thu,) studied this question.
www.synapsesocial.com/papers/69a75fffc6e9836116a2c649 — DOI: https://doi.org/10.4326/jjcvs.55.11
Ryoko Arakaki
Akino Uejo
Kojiro Furukawa
Japanese Journal of Cardiovascular Surgery
University of the Ryukyus University Hospital
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