交連部切開術、正中線脊髄切開

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/09 00:45:03」(JST)

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A commissurotomy is a surgical incision of a commissure in the body, as one made in the heart at the edges of the commissure formed by cardiac valves, or one made in the brain to treat certain psychiatric disorders.

Patients with scleroderma, a disease that thickens and hardens the skin, sometimes require oral commissurotomy to open the corners of the mouth, the commissures, to allow dental treatment. This procedure often leaves characteristic scars.

In cardiac valves

Commissurotomy of cardiac valves is called valvulotomy,^[1] and consists of making one or more incisions at the edges of the commissure formed between two or three valves, in order to relieve constriction such as occurs in valvular stenosis, especially mitral valve stenosis.

In neurosurgery

In neurosurgery,as a treatment for severe epilepsy, the corpus callosum, or the area of the brain that connects the two hemispheres, would be completely bisected. By eliminating the connection between the two hemispheres of a patient's brain, electrical communication would be cut off greatly diminishing the amount and severity of the epileptic seizures. For some, seizures would be completely eliminated.^[2]

Though no effect on behavior was observed after commisurotomy was performed on monkeys, it gave peculiar effects on human perception. Different functions of cognition are predominantly located on one of the hemispheres. For example, Brocas area, crucial for forming sentences, is on most people situated in the left hemisphere ventral to the facial motor cortex. The left hemisphere is referred to as the "talking" hemisphere and the right the "silent". A commisurotomy prevents any sensory input to the silent hemisphere from reaching the talking hemisphere. Since the left visual field is processed in the right hemisphere, a person with a commisurotomy is unable to describe objects to the left, because the "talking" hemisphere has not seen anything. It appears as though the person hadn't seen anything at all, and it doesn't bother him either. It can be demonstrated that stimuli to the right hemisphere for example give emotional response, but because of the severed corpus callosum it cannot be verbalized. ^[3]

References

^ TheFreeDictionary > valvotomy Citing: WordNet 3.0, Farlex clipart collection. © 2003-2008 Princeton University, Farlex Inc.
^ http://search.proquest.com/psycinfo/docview/872086410/fulltextPDF/140EA83459762EBB7BE/2?accountid=13584#
^ , Bear, Connors, Neuroscience third edition

UpToDate Contents

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1. 僧帽弁狭窄症の外科的マネージメント surgical management of mitral stenosis
2. 僧帽弁狭窄症に対する経皮的バルーン僧帽弁切開術 percutaneous mitral balloon valvotomy for mitral stenosis
3. 僧帽弁狭窄症における内科的マネージメントおよびインターベンションの適応 medical management and indications for intervention for mitral stenosis
4. 高齢者の弁膜症 valvular heart disease in elderly adults
5. Pathophysiology and natural history of mitral stenosis

English Journal

Percutaneous transseptal mitral commissurotomy in a patient with absent right superior vena cava and aneurysmally dilated coronary sinus.

Srinivas BC, Singla V, Reddy B, Nagesh CM, Nanjappa MC.SourceDepartment of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, 560069, Karnataka, India.
Cardiovascular intervention and therapeutics.Cardiovasc Interv Ther.2013 Oct;28(4):419-21. doi: 10.1007/s12928-013-0196-6. Epub 2013 Jul 11.
Percutaneous transseptal mitral commissurotomy (PTMC) is the first line of treatment for selected patients of rheumatic mitral stenosis. Transseptal puncture is the most crucial step for performing a safe and successful PTMC. The distorted cardiac anatomy can lead to technical difficulties and incre
PMID 23842850

Is rheumatic aetiology a predictor of poor outcome in the current era of mitral valve repair? Contemporary long-term results of mitral valve repair in rheumatic heart disease.

Yakub MA, Dillon J, Krishna Moorthy PS, Pau KK, Nordin MN.SourceDepartment of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2013 Oct;44(4):673-81. doi: 10.1093/ejcts/ezt093. Epub 2013 Feb 27.
OBJECTIVES: Contemporary experience with mitral valve (MV) repair in the rheumatic population is limited. We aimed to examine the long-term outcomes of rheumatic MV repair, to identify the predictors of durability and to compare the repair for rheumatic and degenerative MVs.METHODS: MV repairs for b
PMID 23447474

Leaflet extension in rheumatic mitral valve reconstruction.

Dillon J, Yakub MA, Nordin MN, Pau KK, Krishna Moorthy PS.SourceDepartment of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2013 Oct;44(4):682-9. doi: 10.1093/ejcts/ezt035. Epub 2013 Feb 13.
OBJECTIVES: Type IIIa mitral regurgitation (MR) due to rheumatic leaflet restriction often renders valve repair challenging and may predict a less successful repair. However, the utilization of leaflet mobilization and extension with the pericardium to increase the surface of coaptation may achieve
PMID 23407161

Japanese Journal

A case of severe aortic valve stenosis including triple-vessel ischemic heart disease in which multidisciplinary percutaneous coronary intervention and balloon aortic valvuloplasty relieved low cardiac output syndrome

Komiyama Kota,Tejima Tamotsu,Ashikaga Takashi [他]
Cardiovascular intervention and therapeutics 30(3), 260-265, 2015-07
NAID 40020575075

CASE REPORT : Percutaneous mitral commissurotomy in rheumatic mitral stenosis associated with cor triatriatum

Devidutta Soumen,Narang Rajiv,Saxena Anita [他]
Cardiovascular intervention and therapeutics 30(2), 185-187, 2015-04
NAID 40020473817

心筋保護に工夫を要した4回目心臓手術の1症例

本田威,桒田憲明,滝内宏樹,山澤隆彦,渡部芳子,古川博史,柚木靖弘,田淵篤,正木久男,種本和雄
日本心臓血管外科学会雑誌 44(4), 208-211, 2015
CABG後の再手術において心筋保護の投与方法はしばしば問題とされる．症例は69歳女性，僧帽弁非直視下交連切開術（CMC），大動脈弁および僧帽弁置換術（DVR），冠動脈バイパス術（CABG）と3回の手術歴があり，僧帽弁の弁周囲逆流（PVL）による溶血性貧血にて僧帽弁再置換術および右冠動脈へのグラフト閉塞に対しCABGを行った．左冠動脈起始部（LMT），右冠動脈（RCA）は完全に閉塞していたため，左冠 …
NAID 130005090717

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リンク元	「交連部切開術」「交連切開術」「正中線脊髄切開」
拡張検索	「open mitral commissurotomy」「percutaneous transluminal mitral commissurotomy」