僧帽弁閉鎖不全症を伴った心サルコイドーシスに対し僧帽弁置換術を施行した１例

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  • A SURGICAL CASE OF CARDIAC SARCOIDOSIS WITH MITRAL INSUFFICIENCY PERFORMED MITRAL VALVE REPLACEMENT

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We report a case of mitral insufficiency presented with symptoms like dilated cardiomyopathy in which a biopsy of the papillary muscle during mitral valve replacement first offered the diagnosis of cardiac sarcoidosis, together with a review of the literature.<br> A 68-year-old woman was found having mitral insufficienly on cardiac catheter examination and complete atrioventricular block on electrocardiogram when she visited another hospital because of impaired hepatic function and cardiac enlargement on a chest x-ray film in 2001. At that time the patient underwent implant of DDD type cardiac pacemaker. In August 2003, the patient had symptomatic exacerbation of cardiac failure and was admitted to the hospital for the purpose of receiving therapy for cardiac insufficiency. On physical examinations holosystolic murmur was heard at the apex cordis. Chest x-ray films visualized no lymph node swelling at the bilateral hili of lung. Echocardiography showed remarkable decline of cardiac function, ejection fraction of 32%, and cardiac enlargement and IV degree of mitral regurgitation as shown by left ventricular end-diastolic dimension of 75mm and end-systolic dimension of 62mm. So mitral valve replacement was carried out. Intraoperative biopsy of the papillary muscle offered the diagnosis of cardiac sarcoidosis.

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