日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Pediatric Cardiology and Cardiac Surgery 32(1): 38-42 (2016)
doi:10.9794/jspccs.32.38

症例報告症例報告

特異な左室内隔壁を伴う左室二腔症2歳児に対する手術経験Double-chambered Left Ventricle Associated with an Unusual Interventricular Wall: A Case Report

1埼玉県立小児医療センター心臓血管外科Department of Cardiovascular Surgery, Saitama Children’s Medical Center, Saitama, Japan

2埼玉県立小児医療センター循環器科Department of Cardiology, Saitama Children’s Medical Center, Saitama, Japan

受付日:2015年8月6日Received: August 6, 2015
受理日:2015年10月13日Accepted: October 13, 2015
発行日:2016年1月1日Published: January 1, 2016
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胎児期,および出生直後の心エコーではともに構造異常を認めなかった左心室腔内に,生後1歳2ヶ月時に隔壁構造を指摘された.隔壁により二腔化された左室内心尖腔(副腔)に血栓を生じるとともに急速な副腔の収縮機能低下をきたした2歳男児に対して緊急手術にて血栓除去および隔壁部分切除術を行った.僧帽弁乳頭筋が付着している隔壁部分は温存した.術直後から副腔機能は改善し,血栓再発や僧帽弁逆流は見られていない.異常隔壁の発生・発達に極めて特異な経過をとった,左室二腔症の手術例を報告する.

We report a very unusual case of a double-chambered left ventricle. A muscular partition, in the left ventricle, associated with a double-chambered left ventricle, was discovered in a boy aged 14 months. No cardiac structural abnormality had been detected previously. At the age of two years, and weight of 11 kg, he was admitted to our medical center because of a systemic convulsion. Further diagnosis was made, considering brain infarction because of a left ventricular thrombus. Preoperative echocardiography showed severely depressed function of the apical chamber of the left ventricle with an embedded thrombus. The patient required an urgent thrombectomy concomitant with partial resection of the muscular partition wall between the apical and outlet chambers. Complete resection of the partition would have led to mitral valve dysfunction because of its continuity with the mitral papillary muscle. Postoperatively, the patient has been doing well with neither thrombus formation nor cardiac dysfunction.

Key words: double-chambered left ventricle; partition; mitral valve; papillary muscle; thrombus

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This page was last modified on 2016-01-26T09:54:45.296+09:00


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