A Case of Surgical Repair for Left Ventricular Septal Perforation with Septal Dissection due to Acute Myocardial Infarction

症例は71歳の男性.急性下壁心筋梗塞(AMI: acute myocardial infarction)後の心不全増悪を契機に心室中隔解離を伴う心室中隔穿孔(VSP: ventricular septal perforation) を認めた.心不全症状は大動脈バルーンパンピングと利尿剤の使用で安定したため,AMI発症から23日目,VSP同定から12日目に左室切開アプローチでVSP閉鎖術を行った.右室側穿孔部は単純にパッチ閉鎖し,左室側穿孔部は2重パッチによるinfarct exclusion法に準じて閉鎖した.中隔解離腔にはBioGlue Surgical Adhesive(Artivion, Inc.Kennesaw, GA, USA)を封入した.経過は良好であり,術後36日目に自宅退院となった.術後1年6カ月が経過し,NYHA I度で外来通院中である.

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Publication Details

Journal
Japanese Journal of Cardiovascular Surgery
Published
2025-01-15
DOI
https://doi.org/10.4326/jjcvs.54.1
Primary Topic
Cardiac Structural Anomalies and Repair
Type
article
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article

A Case of Surgical Repair for Left Ventricular Septal Perforation with Septal Dissection due to Acute Myocardial Infarction

Japanese Journal of Cardiovascular Surgery
Cardiac Structural Anomalies and Repair
article

A Case of Surgical Repair for Left Ventricular Septal Perforation with Septal Dissection due to Acute Myocardial Infarction

article en

Abstract

症例は71歳の男性.急性下壁心筋梗塞(AMI: acute myocardial infarction)後の心不全増悪を契機に心室中隔解離を伴う心室中隔穿孔(VSP: ventricular septal perforation) を認めた.心不全症状は大動脈バルーンパンピングと利尿剤の使用で安定したため,AMI発症から23日目,VSP同定から12日目に左室切開アプローチでVSP閉鎖術を行った.右室側穿孔部は単純にパッチ閉鎖し,左室側穿孔部は2重パッチによるinfarct exclusion法に準じて閉鎖した.中隔解離腔にはBioGlue Surgical Adhesive(Artivion, Inc.Kennesaw, GA, USA)を封入した.経過は良好であり,術後36日目に自宅退院となった.術後1年6カ月が経過し,NYHA I度で外来通院中である.

Japanese Journal of Cardiovascular SurgeryVol. 54(1)
Sasebo City General Hospital (JP), Nagasaki University Hospital (JP)
Reduced inequalities
Openalex Percentile: Top 35%
Cardiac Structural Anomalies and Repair
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A Case of Surgical Repair for Left Ventricular Septal Perforation with Septal Dissection due to Acute Myocardial Infarction · Japanese Journal of Cardiovascular Surgery (2025) | TGRS Research Map | TGRS