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
Pediatric Cardiology and Cardiac Surgery 32(1): 50-53 (2016)


鈍的外傷による心室中隔穿孔に対して手術を行った一例Ventricular Septal Perforation after Blunt Chest Trauma: A Case Report

1熊本市民病院小児心臓外科Department of Pediatric Cardiac Surgery, Kumamoto City Hospital ◇ Kumamoto, Japan

2熊本市民病院心臓血管外科Cardiovascular Surgery, Kumamoto City Hospital ◇ Kumamoto, Japan

3熊本市民病院小児循環器科Pediatric Cardiology, Kumamoto City Hospital ◇ Kumamoto, Japan

4熊本赤十字病院小児科The Department of Pediatrics, Japanese Red Cross Kumamoto Hospital ◇ Kumamoto, Japan

受付日:2015年10月22日Received: October 22, 2015
受理日:2015年12月10日Accepted: December 10, 2015
発行日:2016年1月1日Published: January 1, 2016

胸部鈍的外傷後の心室中隔穿孔に対し受傷後3か月で手術を行い良好な結果を得たので報告する.症例は7歳,男児.学校で遊んでいる際に前胸部を突かれるようにアルミ製のブラインド下端の棒に衝突し鈍的外傷を負った.受傷直後はなかった心雑音を1か月後に聴取し心エコーで心尖部に左右短絡を認めた.その後,易疲労感と左室の拡大傾向を認めたため受傷後3か月で手術を施行した.左室切開アプローチを選択し穿孔部の同定は容易で心尖部中隔に10 mmの亀裂を認めパッチで閉鎖した.術後の経過は良好であった.

Isolated ventricular septal perforation (VSP) due to blunt trauma is rare. We report the case of successful repair of VSP due to blunt chest trauma. The patient was a 7-year-old boy whose chest had collided against the bottom bar of the window shade. He had no obvious injury on the surface of his body and no cardiac murmur at all. However, a pansystolic murmur was heard within a month, and a color Doppler echocardiogram revealed left-to-right shunt flow through a VSP. He underwent surgery three months after the blunt chest trauma. An approximately 10-mm tear with fibrous edges was found in the apical septum, and it was closed by left ventriculotomy using an expanded polytetrafluoroethylene patch. The patient’s postoperative course was uneventful.

Key words: traumatic ventricular septal perforation; blunt chest trauma; cardiac surgery; left ventriculotomy

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