A Case of Surgical Treatment for Cardiac Sarcoidosis
10.4326/jjcvs.38.336
- VernacularTitle:心室中隔基部の瘤化を伴う心サルコイドーシスに対し外科治療を行った1例
- Author:
Hidetoshi Yamauchi
;
Hiroyuki Satoh
;
Tomoyoshi Yamashita
;
Yoshiro Matsui
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2009;38(5):336-339
- CountryJapan
- Language:Japanese
-
Abstract:
A 64-year-old woman who had been followed for complete right bundle branch block at another hospital was found to have heart failure due to cardiac sarcoidosis. She was admitted because of progressive thinning of the ventricular septum and septal aneurysm which protruded into the right ventricle. On echocardiogram, her left ventricular ejection fraction had decreased to 40%. We decided to perform an operation because the patients's heart failure was thought to be due to dyskinesia of the ventricular septum with bulging of the septum into the right ventricle during systole, which consequently decreased cardiac output. The scarred ventricular septum, which was observed through right atrial, right ventricular and aortic incisions, was incised along the marginal normal interventricular myocardium. A tailored 4×3 cm oval Dacron patch was secured over this opening. A DDD pacemaker was implanted for complete atrio-ventricular block and, to synchronize both ventricles, ventricular leads were fixed on the right and left ventricular epicardium. Her postoperative course was uneventful. A postoperative pathologic study revealed a noncaseating granuloma on the border of the normal myocardium. We report a rare surgically treated case of cardiac sarcoidosis.
