[Surgical treatment of left ventricular-right atrial communication complicated with aortic and mitral valves regurgitation: report of a case].
A 50-year-old man with a heart murmur from early childhood and a one year history of general fatigue was admitted. Cardiac examination showed a left ventricular-right atrial (LV-RA) communication, and aortic and mitral valve regurgitation (III/IV). At surgery, the LV-RA communication was located in the atrioventricular membranous portion 3 mm above the septal leaflet of the tricuspid valve. The etiology of the LV-RA communication was congenital and valvular diseases were acquired changes caused by sclerosis due to infected endocarditis or hypertension. The diameter of the LV-RA communication defect was 6 mm, and the fibrous tissue around the defect was closed directly. Next, double-valve replacement was performed safely. However, the day after surgery, the patient developed complete atrioventricular block and implantation of a DDD pacemaker was required. He was discharged without other complication. We recommend the careful closure of the LV-RA communication defect, if the defect is small and rich in fibrous tissue.
Department of Cardiovascular Surgery, Kawasaki Social Insurance Hospital, Kawasaki, Japan.
S
S
Uchikawa
Y
Y
Ito
K
K
Hayashi
T
T
Muramatsu
R
R
Tsukahara
D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D006327:Heart Block; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D016896:Treatment Outcome