動脈管開存症を合併したtunnel typeの大動脈弁下狭窄症の1例

A case of tunnel subaortic stenosis associated with patent ductus arteriosus with severe pulmonary hypertension in middle-aged woman

　Discrete typeの大動脈弁下狭窄症は，欧米ではChe—vers_1）の報告以来多数の報告例があるが，わが国においてはいまだ10数例の報告がなされているのみであり_2,3），稀な疾患と考えられている。われわれは最近，discretetypeの弁下狭窄の中でも稀とされるtunnel typeの大動脈弁下狭窄症_4）に，著明な肺高血圧を有する動脈管開存症を合併した1例を経験したので報告する。

A case of tunnel subaortic stenosis associated with patent ductus arteriosus with severe pulmonary hypertension was presented.

A 41-year-old woman was admitted to thehospital because of palpitation and dyspnea. There was an ejection murmur and a diastolic murmur along the left sternal border.

The echocardiogram showed markedly narrowed left ventricular outflow tract. Cardiac catheter passed easily from the pulmonary artery into the descending aorta through the ductus arteriosus. The blood pressure in the main pulmonary artery was 100 mmHg systolic and 52 mmHg diastolic, and right to left shunt rate revealed 60 percent. Left ventrieulogram demonstrated fixed aortic annulus and subaortic stenosis compatible with the tunnel subaortic stenosis.