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心筋肥大を伴った冠動脈左室瘻(artery-left ventricular fistula,AVF)の2例を経験し,AVFの問題点や肥大型心筋症(hypertrophic cardiomyopathy,HCM)との関連性について検討した.
症例1は53歳男性で,心尖部肥大型心筋症が疑われ,左右冠動脈造影時拡張期に造影剤が左室内に流出した,症例2は46歳男性でび漫性心筋肥厚を認め,左右冠動脈造影時に左室壁が広範囲に染まり,収縮期に左室内が造影された.AVFの流出血管の大きさ,範囲,また流出時相などに関する定義を明確にする必要があるが,AVFとHCMに関連性が疑われた.
Two cases of coronary artery-left ventricular fistula (AVF) associated with left ventricular hypertrophy were reported. The first patient was a 53-year-old man with chest pain. Selective coronary angiography (CAG) revealed bilateral coronary arteries draining into the left ventricle (LV). The second patient was a 46-year old man with electrocardiographic (ECG) abnor-malites. CAG showed bilateral coronary artery which communicated via a maze of fine vessels into LV. In both cases, ECG showed ST depression and inverted T wave, and two-dimensional echocardiography revealed hypertrophic cardiomyopathy (HCM).
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