感染性心内膜炎による冠動脈塞栓症の1治験例

A case of successful surgical repair for infective endocarditis complicating coronary embolism

　冠動脈塞栓症は，Virchowによりはじめて報告されて以来，いくつかの報告をみるが，極めて稀な疾患である。その基礎疾患としては細菌性心内膜炎が最も多く，次いで左心系心腔内血栓が多い。しかし，文献的に心内膜炎に起因する冠動脈塞栓症に対する外科的治療の報告はほとんどない。今回われわれは，僧帽弁疣贅により冠動脈塞栓をきたした急性期心内膜炎の1例に僧帽弁置換術を行い救命したので，文献的考察を加えて報告する。

Coronary embolism is a rare complication of val-vular heart disease. A 56-year-old man received mitral valve replacement for mitral regurgitation with infective endocarditis complicating acute myo-cardial infarction. Although coronary embolism oc-cured just prior to emergent operation, the operation was performed to prevent further embolic episodes 5 hours after the episode. We had to have kept his sternum opened for 2 days after the operation and both IABP and dobutamine infusion were reguired to control LOS, however his recovery was mooth and he is now well.