感染性心内膜炎後の大動脈弁交連部剝離による大動脈基部仮性瘤の1例

Aortic Root Pseudoaneurysm due to Avulsion of Aortic Valve Commissure Following to Infective Endocarditis；Report of a case

はじめに　大動脈弁交連部の剝離（avulsion of aortic valve commissure：AAV）は交通外傷や感染により生じるが，比較的まれな病態である1～3）．また，二尖弁（bicuspid aortic valve：BAV）は感染性心内膜炎（IE）の危険性が高くなることが報告されている4）．われわれは，IEを原因としてAAVを生じ，大動脈基部仮性瘤を発症した1例を経験したので報告する．

A 40-year-old man presented to our hospital with fever and slight palpitation. The echocardiogram revealed bicuspid aortic valve, massive aortic regurgitation, and aneurysm of Valsalva sinus. Operative findings showed an aortic root pseudoaneurysm originating just below the avulsion of the right to left commissure. The orifice was closed with a part of a woven vascular graft, and the aortic valve was replaced with a mechanical valve. There was no sign of marked inflammation, although pathophysiologic findings indicated infective endocarditis. His postoperative course was uneventful.