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  • Title: [Surgical treatment of left ventricular-right atrial communication complicated with aortic and mitral valves regurgitation: report of a case].
    Author: Uchikawa S, Ito Y, Hayashi K, Muramatsu T, Tsukahara R.
    Journal: Kyobu Geka; 2004 Feb; 57(2):123-6. PubMed ID: 14978906.
    Abstract:
    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.
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