Decalcification of Anterior Mitral Valve Leaflet to Repair Moderate Nonrheumatic Mitral Valve Stenosis with Severe Aortic Valve Stenosis / 日本心臓血管外科学会雑誌

A 78-year-old woman was referred to our hospital because of progressive exertional dyspnea due to nonrheumatic severe aortic valve stenosis and moderate mitral valve stenosis with mitral annular calcification. We subsequently performed aortic valve replacement and mitral anterior leaflet decalcification. During surgery, we found that the cause of mitral valve stenosis was calcification of A2 aortic curtain-medial trigon through aortic valve annulus and resected calcification with SONOPET. The postoperative echocardiography revealed good mitral valve motion with mild mitral valve stenosis.

Cardiac Tamponade due to Detachment of the Aortic Valve Commissure / 日本心臓血管外科学会雑誌

A 68-year-old man was taken to our hospital by ambulance due to syncope. He was in shock with cardiac tamponade. Pericardial drainage was performed. Aortic valve regurgitation gradually increased and surgery was performed at 25 days after onset. Surgical finding showed that there was a detachment of the commissure between the right and non coronary cusps of the aortic valve. An intimal tear was detected in the same place and aortic root replacement was required. The patient had a good recovery and he was discharged 14 days after surgery.

A Case Report of Double Valve Replacement for Mucopolysaccharosis with Chest Pain Attack and Severe Heart Failure / 日本心臓血管外科学会雑誌

We report a successfully treated case of double valve replacement for mucopolysaccharosis in a 27-year-old woman. Mucopolysaccharosis had been suspected since she was aged 11. Symptoms of heart failure and chest pain suggested valvular disease and she was referred to us. Echocardiography, aortography and cardioangiography showed aortic regurgitation (grade IV/IV) and mitral regurgitation (grade III/IV). She received double valve replacement and was discharged on the 38th postoperative day with symptom improvement. Although urinalysis was positive for heparan-sulfate, this case could not be diagnosed definitively as mucopolysaccharosis due to normal lymphocytic enzyme-activity. However, large amounts of mucopolysaccharoid deposits were present in her removed aortic and mitral valve leaflets, and her clinical picture corresponded with mucopolysaccharosis. Thus, it was considered that her ultimate diagnosis was combined cardiac valvular disease due to mucopolysaccharosis.

A Case of Coronary Artery Bypass Grafting Using Arterial Grafts in a Patient with Systemic Lupus Erythematosus and Review of the Literature / 日本心臓血管外科学会雑誌

We report a case of coronary artery bypass grafting (CABG) in a patient with systemic lupus erythematosus (SLE). A 24-year-old woman with SLE had been treated with steroids and immunosuppressive agents for 7 years. The patient was admitted to Kumamoto University Hospital for the management of unstable angina. CABG was successfully performed using bilateral internal thoracic arteries and postoperative 3D-CT demonstrated good patency of both arterial grafts. The patient experienced no significant postoperative complications, and has remained well to date (8 months postdischarge).