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英文誌(2004-)

Journal of Medical Ultrasonics

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2011 - Vol.38

Vol.38 No.04

Case Report(症例報告)

(0465 - 0472)

僧帽弁狭窄症と伸展性卵円孔開存によりLutembacher症候群類似の血行動態を示した高齢女性の1例

A case of an elderly female patient presenting a hemodynamic pattern similar to that of Lutembacher’s syndrome due to mitral stenosis and the stretched patent foramen ovale

大沼 芳子1, 水島 浩行1, 石瀬 久也2, 神保 正樹2

Yoshiko ONUMA1, Hiroyuki MIZUSHIMA1, Hisanari ISHISE2, Masaki JINBO2

1姫川病院中央検査部, 2姫川病院内科

1Department of Central Clinical Laboratory, Himekawa Hospital, 2Department of Internal Medicine, Himekawa Hospital

キーワード : percutaneous transvenous mitral commissurotomy, echocardiography, Lutembacher’s syndrome, atrial septal aneurysm, stretched foramen ovale

重症僧帽弁狭窄症のために著明な左房と卵円孔の拡大で心房中隔瘤と心房間左‐右シャントとが生じ,Lutembacher症候群と同様な血行動態になった78歳の女性を報告した.経皮的経静脈的僧帽弁交連切開術が施行されたが,心拍出量の増加は芳しくなく,慢性右心不全の所見を徐々に呈した.左‐右シャントが生じた前後の超音波検査の経過を追うことが出来た稀な症例と考えられた.

We report our experience with a 78-year-old woman who presented with hemodynamics like those of Lutembacher’s syndrome. The patient had an atrial septal aneurysm and an interatrial right-to-left shunt caused by marked enlargement of the left atrium and the foramen ovale resulting from serious mitral stenosis. Although percutaneous transvenous mitral commissurotomy was carried out, subsequent increase in cardiac output was insufficient and chronic heart failure became evident. This suggests the appropriateness of early surgery when the right-to-left shunt appears in cases like this one.