30歳の成人にみられた総肺静脈還流異常症の1例

Total anomalous pulmonary venous return in 30-years old adult

　総肺静脈還流異常症（以下TAPVRと略す）の予後は悪く，乳幼時期に死亡する例が多いとされている。最近，無症状で，チアノーゼもなく経過した30歳の無名静脈還流型のTAPRを経験したのでここに報告し，あわせて予後について文献的考察を行なった。

In TAPVR about 80% of patients had been said to have died before reaching the age of full one year. Among aggravating factors are obstruc-tion of the amolous trunk pulmonary hyper-tension, hypoplastic left hearts and the extent of intraatrial communication. This case was a non-cyanotic 30-year-old woman with no known symp-toms who had given births to two healthy babies. She was told, however, of having an abnormal chest x-ray, i. e., a snowman contur by her family physician. Cardiac catheterization showed anomalous non-obstructive vertical vein connected to the left inominate vein. The oxygen content was 14.7 vol % in the right atrium and 14.1 vol % in the femoral artery. The blood pressure in the main pulmonary artery was 25.6 mmHg sys-tolic and 11.2mm diastolic. The reason why she could reach adulthood with no symptoms is presumed to be due to absence of pulmonary hypertension, existance of large ASD and an excellent mixing of oxygen in the left atrium.