狭小弁輪を伴う,高齢者大動脈弁狭窄症に対し,生体弁(Carpentier Edwards Perimount Magna)による弁置換を施行した1例  [in Japanese] An aortic replacement with a bioprosthesis (Carpentier-Edwards Perimount Magna) for aortic valve stenosis with a small annulus in an elderly patient  [in Japanese]

An 82-year-old female was admitted to our hospital in December 2006 due to dyspnea resulting from cardiac failure accompanied by severe aortic stenosis and pulmonary hypertension. She recovered after medical treatment, but she was admitted again on May 7, 2008 because of exacerbated dyspnea.Echocardiographic examination revealed aortic stenosis with a peak pressure gradient (PG) of 63 mmHg and severe tricuspidal regurgitation (TR).Cardiac catheterization showed an aortic valve area of 0.52㎠. On June 6,2008 she underwent aortic valve replacement (AVR) and tricuspid annuloplasty according to Kay’s method.Although a sizer for a Carpentier-Edwards standard prosthesis of 19 mm could not be inserted,another for a Carpentier-Edwards Perimount Magna prosthesis of 19 mm was inserted, and AVR was accomplished with this bioprosthesis while avoiding aortic annular enlargement. The patient recovered uneventfully and was discharged on the twelfth-postoperative-day. The results of postoperative echocardiography were ejection fraction 61%, mean PG 14 mmHg and, mild TR.