内臓逆位に静脈心室流出路狭窄を伴った高齢（80歳）修正大血管転位症の1女性剖検例

An Autopsy Case of an Eighty-year-old Female with Corrected Transposition of Great Arteries, Situs Inversus and Venous Ventricle Out-flow Stenosis

　症例は80歳，女性．20歳時より全内臓逆位を指摘されていた．66歳時，労作時呼吸困難にて当科入院．下大静脈還流異常，左側大動脈弓を伴ったCardell-B4 typeの修正大血管転位，全内臓逆位と診断された．本例は収縮期雑音があり，静脈心室流出路狭窄が証明された．その後心不全，上室性頻拍で入院を繰り返した．1992年心停止呼吸停止状態にて来院し死亡．剖検にて，上記臨床診断に一致する所見に加えて，両側三葉肺が存在した．本例の静脈心室流出路狭窄は心室中隔欠損の自然閉鎖孔に形成された心室中隔の瘤状瘢痕組織によると考えられた．修正大血管転位症の高齢者例は少なく，本例は本邦最高齢の報告である．

An autopsy of an eighty-year-old female, whom we had diagnosed as having corrected transposition of great arteries (C-TGA), situs inversus and venous ventricle stenosis, 10 years prior to her death, was carried out. The autopsy revealed that the stenosis of the venous ventricular outflow-tract was caused by scar tissues which had formed following spontaneous closure of a ventricular septal defect, and that the inverted left lung in the right side of thoracic cage consited of 3 lung lobes including an accessory midlobe. This case may be that of the oldest patient with C-TGA to have been reported in Japan.