A Fourteen-Day-Old Neonate with Congenital Aortic Valve Stenosis Successfully Treated with Open Valvular Commissurotomy.
10.4326/jjcvs.22.437
- VernacularTitle:生後14日目に直視下交連切開術を行い救命した先天性大動脈弁狭窄症の1例
- Author:
Yuji HIRAMATSU
;
Naotaka ATSUMI
;
Masakazu ABE
;
Tomoaki JIKUYA
;
Yuzuru SAKAKIBARA
;
Tatsuo TSUTSUI
;
Kenji OKAMURA
;
Toshio MITSUI
;
Motokazu HORI
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1993;22(5):437-440
- CountryJapan
- Language:Japanese
-
Abstract:
A thirteen-day-old neonate was admitted because of systolic heart murmur, tachycardia, tachypnea and sucking weakness. The chest X-ray film demonstrated remarkable cardiomegaly and pulmonary congestion. Echocardiography detected marked thickening and stenosis of the aortic valve, and left ventricular dysfunction (EF=10%). The pressure gradient between left ventricle and ascending aorta was presumed 130mmHg with pulsed Doppler echocardiography, Since he did not respond to conservative treatment, an emergency open aortic valvular commissurotomy under cardiopulmonary bypass was performed the day after admission. We made incisions of 1mm in the left side and 0.5mm in the right side commissure of the adherent bicuspid aortic valve. After the procedure, left ventricular function improved (EF=57%), and the pressure gradient was reduced to 62mmHg. He showed good recover from the congestive heart failure. There are few reports about operative treatment of congenital aortic valve stenosis in neonates. This is considered to be the third youngest successful operative case of open aortic valvular commissurotomy in Japan.