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Kokyu to Junkan Volume 35, Issue 4 （April 1987）

呼吸と循環 35巻4号（1987年4月発行）

Japanese English

症例

PTCAにより左心機能の改善を得た陳旧性心筋梗塞の3例 Report of three cases with myocardial infarction employed with successful treatment with PTCA 上野哲哉 ¹ , 渡辺健介 ¹ , 安倍由美子 ¹ , 森山敦夫 ¹ , 猪狩民生 ¹ , 古賀伸彦 ¹ , 戸次久敏 ² , 高地恭二 ³ Tetsuya Ueno ¹ , Kensuke Watanabe ¹ , Yumiko Abe ¹ , Astuo Moriyama ¹ , Tamio Ikari ¹ , Nobuhiko Koga ¹ , Hisatoshi Bekki ² , Kyoji Kohchi ³ ¹古賀病院 ²久留米大学第3内科 ³福岡大学第2病理 ¹The Koga Hospital ²The 3rd Department of Internal Medicine, Kurume University School of Medicine ³The 2nd Department of Pathology, Fukuoka University School of Medicine pp.447-452

発行日 1987年4月15日 Published Date 1987/4/15

DOI https://doi.org/10.11477/mf.1404205048

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Abstract 文献概要
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　PTCAは，狭心症に対する画期的な治療法として急速に普及し，カテーテルシステムの改良や手技の向上に伴い，その適応も，多枝病変や不安定狭心症または急性心筋梗塞に対しても施行され，その治療効果の報告も数多くなった。当院では，昭和59年5月より昭和60年9月まで130例のPTCAを施行したが，既往歴，ECGまたは心筋シンチ上陳旧性心筋梗塞と診断された3症例に対してPTCAを施行し，術前後の心筋シンチ，心プールシンチ，右心カテーテル検査等の比較検討の結果，左心機能の改善が得られたので，文献的考察を含め報告する。

Three cases with old myocardial infarction showed successful improvements in left ventricular function using PTCA treatment. We compared and evaluated both pre and post results employing myocardial scin-tigram, radionucleoid angiography, and right heart catheterization.

Case 1 : A 56-year-old man showed congestive heart failure due to old myocardial infarction. Successful dilatation of LAD showed increase in LVEF from 7% to 20% and of cardiac index from 2.18 to 2.94l/ min･m². Furthermore the exertional dyspnea impro-ved remarkably after PTCA.

Case 2: A 77-year-old woman complained of exer-tional chest and back pains. By dilating both LAD and Cx, remarkable improvements in LVEF was ob-tained and perfusion defect in anteroseptal wall was also admitted by myocardial scintigram.

Case 3 : A 64-year-old man showed total occlusion in Seg 11 and was dilated up to 90% stenosis with a little increase in LVEF.

Our experiences proved the efficacy of PTCA for the cases of myocardial infarction which had no lon-ger been expected to get functional recovery. It might be concluded that PTCA is a new useful method for the treatment of chronic heart failure due to myocar-dial infarction.