Surgical treatment of left ventricular-right atrial communication complicated with aortic and mitral valves regurgitation: report of a case

• Published in: Kyobu geka. The Japanese journal of thoracic surgery Vol. 57; no. 2; p. 123
• Main Authors: Uchikawa, S, Ito, Y, Hayashi, K, Muramatsu, T, Tsukahara, R
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-02-2004
• Subjects: Aortic Valve Insufficiency - complications; Aortic Valve Insufficiency - surgery; Cardiac Surgical Procedures; Heart Block; Heart Septal Defects, Atrial - complications; Heart Septal Defects, Atrial - surgery; Heart Septal Defects, Ventricular - complications; Heart Septal Defects, Ventricular - surgery; Heart Valve Prosthesis Implantation; Humans; Male; Middle Aged; Mitral Valve Insufficiency - complications; Mitral Valve Insufficiency - surgery; Postoperative Complications; Treatment Outcome
• ISSN: 0021-5252

A 50-year-old man with a heart murmur from early childhood and a one year history of general fatigue was admitted. Cardiac examination showed a left ventricular-right atrial (LV-RA) communication, and aortic and mitral valve regurgitation (III/IV). At surgery, the LV-RA communication was located in the atrioventricular membranous portion 3 mm above the septal leaflet of the tricuspid valve. The etiology of the LV-RA communication was congenital and valvular diseases were acquired changes caused by sclerosis due to infected endocarditis or hypertension. The diameter of the LV-RA communication defect was 6 mm, and the fibrous tissue around the defect was closed directly. Next, double-valve replacement was performed safely. However, the day after surgery, the patient developed complete atrioventricular block and implantation of a DDD pacemaker was required. He was discharged without other complication. We recommend the careful closure of the LV-RA communication defect, if the defect is small and rich in fibrous tissue.