| Japanese |
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| Title | SJM Trifecta(TM)生体弁を用いた右小開胸大動脈弁置換手術(MICS-AVR)の1例 |
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| Subtitle | 症例 |
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| Authors | 近藤俊一*1, 高野智弘*1, 中村健*1, 六角丘*2, 横山斉*3 |
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| Organization | *1いわき市立総合磐城共立病院心臓血管外科, *2獨協医科大学越谷病院心臓血管外科呼吸器外科, *3福島県立医科大学心臓血管外科 |
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| Journal | 循環制御 |
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| Volume | 33 |
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| Number | 3 |
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| Page | 209-212 |
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| Year/Month | 2012/12 |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「はじめに」生体弁の耐久性の向上, 心臓再手術のリスク低下, 大動脈弁置換手術(AVR)を受ける患者の高齢化, AVRをうける若年者がワルファリン内服を嫌うこと, そして大規模trialで生体弁の優位性が示されたことにより, AVRにおける生体弁の使用頻度が年々高まりつつある1, 2). 今までに日本に導入された生体弁はいずれも弁尖(牛心膜やブタ大動脈弁)を支える骨格(ステント)に縫い付け, そのステント部分をポリエステル布や, 牛心膜で覆った形状を有していた(図1). 2012年6月に導入されたSJM Trifecta(TM)生体弁は大動脈弁位専用で, ステントに対してリーフレットが外付けのユニークな形状が用いられている(図2). そのデザインにより低い圧較差が得られ, 優れた血行動態を実現できると言われている. 今回我々は, 右第3肋間小切開アプローチ下に, SJM Trifecta(TM)生体弁を使用し, 良好な血行動態を得ることができたので報告する. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | tissue valve, MICS, AVR, Trifecta |
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| English |
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| Title | A Case of Minimally Invasive Aortic Valve Replacement Surgery Using a 19 mm SJM Trifecta(TM) Bioprosthetic Valve |
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| Authors | Shunichi Kondo*1, Tomohiro Takano*1, Ken Nakamura*1, Kyu Rokkaku*2, Hitoshi Yokoyama*3 |
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| Organization | *1Department of Cardiovascular Surgery, Iwaki City General Iwaki Kyoritsu Hospital, *2Department of Thoracic and Cardiovascular Surgery, Dokkyo Medical University Koshigaya Hospital, *3Department of Cardiovascular Surgery, Fukushima Medical University, School of Medicine |
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| Journal | Circulation Control |
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| Volume | 33 |
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| Number | 3 |
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| Page | 209-212 |
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| Year/Month | 2012/12 |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control in Medicine |
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| Abstract | A St. Jude Medical (SJM) Trifecta valve was developed as a new tissue valve by improving the previous tissue valve. The effective orifice area is wider than that of Epic tissue valve. The efficacy of the new valve has not been reported yet. Recently, we first performed aortic valve replacement (AVR) with the SJM Trifecta valve for aortic valve stenosis. A case 74-year-old female was admitted to our hospital with dyspnea and angina on exertion. She was diagnosed aortic valve stenosis. She underwent AVR with a 19 mm Trifecta(TM) tissue valve. According to the intra-operative direct simultaneous pressure measurement conducted after weaning of cardio pulmonary bypass, the peak pressure gradient of the prosthetic valve was 11 mmHg, the mean pressure gradient was 5 mmHg. According to the results of echocardiography conducted 10 days postoperatively, the peak pressure gradient of the prosthetic valve was 24.4 mmHg, the mean pressure gradient was 16.5 mmHg. She was discharged 18 days after surgery without complications. Implantation of a 19mm SJM Trifecta(TM) valve produced excellent result reflected by lower pressure gradient and absence of patient-prosthetic mismatch. In the future, the new valve is expected to be the optimum tissue valve for a narrow annulus. |
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| Practice | Basic medicine |
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| Keywords | tissue valve, MICS, AVR, Trifecta |
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