@article{oai:nagasaki-u.repo.nii.ac.jp:00017671,
 author = {松丸, 一朗 and 江石, 清行 and 山近, 史郎 and 迫, 史朗 and 有吉, 毅子男 and 高井, 秀明 and 中路, 俊 and 安倍, 邦子 and 林, 徳真吉},
 issue = {6},
 journal = {日本心臓血管外科学会雑誌, Japanese Journal of Cardiovascular Surgery},
 month = {Nov},
 note = {若年女性に対しステントレス弁大動脈弁置換術後,オーバーサイジングsub-coronary法が原因と考えられた大動脈弁狭窄症に対する再手術例を経験した. 症例は17歳,女性12歳時に他院にて21mm Freestyle stentless porcine valve(Freestyle生体弁)を用い,modified sub-coronary法にて大動脈弁置換術(AVR)を施行された.術直後より心不全が続いていたが,手術5年後に心臓カテーテル検査で大動脈弁収縮期圧較差が115mmHgである弁輪部狭窄が顕在化し心不全症状が再悪化したため,今回当科にて弁輪拡大術を併用したATS AP 18mmによるAVRを施行した.術中所見として,Freestyle生体弁がオーバーサイジングsub-coronary法で縫着されたことが弁輪部狭窄の原因に関与している可能性が示唆された., We present a successfully treated case of re-operation for aortic valvular stenosis caused by implantation of a stentless prosthesis using oversizing sub-coronary insertion in a young woman. The 17-year-old Japanese woman received aortic valve replacement (AVR) with a 21 mm Freestyle stentless porcine valve (Medtronic Inc.), using the oversizing modified sub-coronary insertion because of infectious endocarditis 12 years previously at another hospital. Just after the operation, she suffered severe heart failure. At 16 years old, since a cardiac murmur and dyspnea on effort appeared, and she presented severe heart failure due to significant aortic valvular stenosis with a mean aortic valve gradient 115 mmHg, we performed aortic valve re-replacement (ATS AP 18 mm) with an aortic root enlargement procedure. Intraoperative findings suggested that the oversizing technique was related to aortic valvular stenosis. The postoperative course has been uneventful., 日本心臓血管外科学会雑誌, 33(6) pp. 425-428; 2004},
 pages = {425--428},
 title = {Freestyle生体弁移植後の弁輪部狭窄に対し大動脈弁輪拡大術を併用施行した大動脈弁再置換術の1例},
 volume = {33},
 year = {2004}
}