Résumé
A 75-year-old man with a heart murmur and fatigability was referred to our hospital. We diagnosed unruptured giant right sinus of Valsalva aneurysm that obstructed the right ventricular outflow tract by echocardiography (UCG), computed tomography (CT) and magnetic resonance imaging (MRI). The right ventricle was dilated and its ejection fraction was decreased to 9.3% by MRI. Successful surgical repair involved the right sinus of Valsalva plasty using a bovine pericardial patch and resection of the aneurysm through only a right ventricular outflow incision. His postoperative course was uneventful.
Résumé
Mitral valve surgeries for cases with mitral annular calcification (MAC) are challenging because of the operative complications. For a case of MS with MAC, we achieved mitral valve plasty by ultrasonic decalcification alone. An 82-year-old male with edema and dyspnea was diagnosed with AS and MS with MAC. MAC was so severe that MVR was challenging. There were calcifications at the anterior commissure and the anterior mitral leaflet (AML), and removal of them was expected to improve the valve function. Therefore, anterior commissurotomy and ultrasonic decalcification of the anterior commissural annulus was performed using cavitron ultrasonic surgical aspiration (CUSA). Following the resection of the aortic valve, we carried out decalcification of the AML through the aortic valve orifice. After AVR, a trans-esophageal echocardiogram showed MS was ameliorated. Two years after surgery, recurrence of MS was not recognized. Some mitral cases with MAC can be treated by only decalcification to avoid risky valve replacement.