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英文誌(2004-)

Journal of Medical Ultrasonics

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1996 - Vol.23

Vol.23 No.06

Case Report(症例報告)

(0447 - 0453)

大動脈四尖弁と細菌性心内膜炎による裂孔を伴った大動脈弁閉鎖不全症の1症例: 経胸壁および経食道心エコー図法による観察

A Case of Aortic Regurgitation Resulting From Quadricuspid Aortic Valve and Aortic Valve Fenestrations Caused by Infective Endocarditis: Observation With Transthoracic and Transesophageal Echocardiography

山崎 忠男1, 石光 敏行1, 平沼 ゆり1, 神谷 英樹1, 榎本 強志1, 芳賀 厚子1, 杉下 靖郎1, 稲葉 武2, 出沢 文子2, 寺田 康3, 三井 利夫3

Tadao YAMAZAKI1, Toshiyuki ISHIMITSU1, Yuri HIRANUMA1, Hideki KAMIYA1, Tsuyosi ENOMOTO1, Atsuko YOSHIGA1, Yasurou SUGISHITA1, Takeshi INABA2, Fumiko DEZAWA2, Yasushi TERADA3, Toshio MITSUI3

1筑波大学臨床医学系内科, 2筑波大学附属病院機能検査部, 3筑波大学臨床医学系外科

1Department of Internal Medicine, Tsukuba University Institute of Clinical Medicine, 2Laboratory Section, Tsukuba University Institute of Clinical Medicine, 3Department of Surgery, Tsukuba University Institute of Clinical Medicine

キーワード : Aortic regurgitation, Aortic valve fenestrations, Infective endocarditis, Quadricuspid aortic valve, Transesophageal echocardiography

A 66-year-old man was admitted to this institution in February 1995 for evaluation of heart failure that occurred after he received a blood transfusion. A loud to-and-fro murmur was audible along the left sternal border. Hematocrit was 21.6%, CRP was elevated, and β-hemolytic streptococci was isolated in the blood culture. Transthoracic and transesophageal echocardiography showed aortic regurgitation and four cusps of equal size on the aortic valve with vegetation and fenestrations in the center of the right and noncoronary cusps, and these findings were visually confirmed on surgery. This is the first reported case of quadricuspid aortic valve associated with infective endocarditis that was diagnosed by echocardiography before surgery. Thirty-two other cases of quadricuspid aortic valve reported in Japan are also reviewed here.