[Double valve replacement for secondary atrioventricular regurgitation due to dilated cardiomyopathy--a case report]

A successful surgical case of double valve replacement for a patient with dilated cardiomyopathy was performed. A 45-year-old man was admitted to our hospital with paroxysmal atrial fibrillation and congestive heart failure. Echo cardiogram and cineangiography showed dilatation and decreased contraction of the left ventricle. A diagnosis of dilated cardiomyopathy was established since neither coronary artery disease nor valvular disease were observed. He was treated with medication of diuretics and pacemaker implantation. However, mitral and tricuspid regurgitation occurred and progressed 7 years later. Since then, he repeated admission and discharge against the strong medication. He became medically uncontrollable at the age of 58. Because of this, surgical treatment had to be considered. Double valve replacement for mitral and tricuspid valve was performed on September, 1989. Avoidance of cardiopulmonary bypass was only possible with the aid of catecholamine. Poor left ventricular function and pleural effusion frequently shown on chest X-ray film complicated the postoperative course. And with hospital treatment, he discharged three months after the operation. He has been doing well without any significant complaint during the past two years and cardiomegaly has been decreasing as well.