林 重孝¹, 成瀬 亘¹, 酒匂 睦郎¹, 石原 均², 恒川 純², 関 章³, 岩瀬 正嗣⁴

Shigetaka HAYASHI¹, Wataru NARUSE¹, Mutsuro SAKOU¹, Hitoshi ISHIHARA², Atsushi TSUNEKAWA², Akira SEKI³, Masatsugu IWASE⁴

¹岡崎市立岡崎病院臨床検査科生理検査室, ²岡崎市立岡崎病院循環器科, ³岡崎市立岡崎病院心臓血管外科, ⁴藤田保健衛生大学循環器内科

¹Department of Clinical Laboratory Okazaki City Hospital, ²Department of Cardiology Okazaki City Hospital, ³Department of Vascular Surgery Okazaki City Hospital, ⁴Department of Cardiology Fujita Health University

キーワード : Double orifice of mitral valve, Pericardial echocardiography, Transthoracic echocardiography

Double orifice of the mitral valve (DOMV) is a rare anomaly often associated with other congenital malformations, especially with endocardial cushion defect. The case of a 36-year-old man with DOMV and no associated anomalies is reported here. Preoperative transthoracic echocardiography showed prolapse of the posterior mitral leaflet and moderate to severe regurgitation. The existence of the DOMV was not suspected, however. Intraoperative direct pericardial echocardiography clearly showed the orifice of the mitral valve to be divided into two openings by bridging tissue, indicating DOMV. No other cardiac anomalies were found. The preoperative diagnosis was mitral valve prolapse, and valvuloplasty was planned. DOMV was identified during openheart surgery, however, so valve replacement was performed instead of valvuloplasty. Postoperative course was uneventful, and the patient recovered and was discharged 43 days after surgery.