野村 公達¹, 矢崎 善一², 宮下 雅子¹, 大槻 幸子¹, 熊谷 豊¹, 宮澤 寿幸¹, 高橋 康之¹, 日吾 雅宜¹, 中澤 功¹

Koutatsu NOMURA¹, Yoshikazu YAZAKI², Masako MIYASHITA¹, Sachiko OOTSUKI¹, Yutaka KUMAGAI¹, Hisayuki MIYAZAWA¹, Yasuyuki TAKAHASHI¹, Masanobu HIGO¹, Kou NAKAZAWA¹

¹国立病院機構まつもと医療センター臨床検査科, ²国立病院機構まつもと医療センター循環器科

¹Division of Clinical Laboratory, National Hospital Organization Matsumoto Medical Center, ²Division of Cardiology, National Hospital Organization Matsumoto Medical Center

キーワード : quadricuspid aortic valve, aortic regurgitation, transthoracic echocardiography

大動脈四尖弁は大動脈弁閉鎖不全の原因となり，稀な先天性心奇形である．今回我々は経胸壁心臓超音波検査により診断可能であった大動脈四尖弁の1症例を経験した．症例は76歳，男性，呼吸困難及び心窩部痛を主訴に近院を受診し，精査目的で当院に紹介入院となった．経胸壁心臓超音波検査では左室の拡大と心収縮能の低下を認めた．また，大動脈弁は右冠尖と左冠尖の間に副尖を有する大動脈四尖弁が確認され，大動脈弁中央部の接合不全による重度大動脈弁逆流を伴っていた．大動脈造影においても重度大動脈弁逆流が確認され大動脈弁置換術が施行された．本症例は経胸壁心臓超音波検査を契機に大動脈四尖弁と診断された貴重な症例と考え報告する．

Quadricuspid aortic valve is a rare congenital cardiac anomaly that causes aortic regurgitation. We used transthoracic echocardiography to diagnose a case of quadricuspid aortic valve. The patient was a 76-year-old man with dyspnea and epigastralgia and who had been examined by a general practitioner. He was subsequently hospitalized at this institution when heart failure was indicated. Transthoracic echocardiography showed left ventricular dilatation and systolic dysfunction. The aortic valve was quadricuspid and had an accessory cusp between its right and the left cusps, thus causing severe aortic regurgitation resulting from coaptation failure. The valve was replaced when aortography also revealed severe aortic regurgitation. This case is valuable for having provided the basis for a definitive diagnosis of quadricuspid aortic valve from findings obtained using transthoracic echocardiography.