| Successful Surgical Correction
of an Incomplete Endocardial Cushion Defect in an Elderly Patient |
(Department of Cardiovascular Surgery, Mito National
Hospital, Mito, Japan and Department of Cardiovascular Surgery,
Graduate School of Medicine, Tohoku University*, Sendai, Japan)
| Takeshi Saito* |
Naoki Uchida |
Junitu Akasaka* |
| Goro Takahashi* |
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A successful surgical correction
of an incomplete endocardial cushion defect (ECD) with an ostium
primum defect in a 63-year-old man is reported. Incomplete ECD
with ostium primum defect often causes severe heart failure in
infancy. Reports of its surgical correction in elderly patients
are few. The patient had upper abdominal discomfort and grade
1 mitral valve regurgitation. The preoperative diagnosis was
complete ECD (Rastelli typeA) because we misdiagnosed a leakage
from a cleft between the left superior leaflet and the left inferior
leaflet for a flow through a ventricular septal defect when we
analyzed a preoperative left ventriculography. The importance
of not misdiagnosing the leakage and echocardiography in preoperative
diagnosis of ECD was therefore realized. The operative procedure
involved patch closure of the ostium primum defect and mitral
valve annuloplasty by Kay's procedure and the mitral valve regurgitation
completely disappeared. The postoperative course was uneventful.
The upper abdominal discomfort and cardiomegaly improved. If
there is no severe dysfunction of other organs, surgical correction
of incomplete ECD should be recommended even for elderly patients.
Jpn. J. Cardiovasc. Surg. 31：395-398 (2002) |
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