特発性肺動脈瘤

Idiopathic Pulmonary Artery Aneurysm

特発性肺動脈瘤はまれな疾患であり，Deterlingらは約11万例の病理解剖で8例（約0.007％）に認めたのみであったと報告している．そのため治療法や予後は明らかでない部分が多いが，瘤の大きさ，急速な拡大，周囲臓器の圧迫症状，肺高血圧の合併，瘤内の血栓，解離や破裂が手術適応とされている1）．われわれは，拡大傾向を呈する径60 mmの特発性肺動脈瘤の1手術例を経験したので報告する．

Pulmonary artery aneurysm （PAA） is usually associated with congenital heart disease, pulmonary artery hypertension, and connective tissue abnormalities, but idiopathic PAA is a rare clinical entity. We experienced a surgical case of idiopathic PAA measuring 60 mm in diameter. A 72-year-old man had been admitted to a nearby hospital 5 years before because of an abnormal shadow on chest X-ray, and was diagnosed with an idiopathic PAA measuring 37 mm in diameter. The PAA gradually expanded during follow-up and surgery was scheduled. Aneurysmal resection and reconstruction with a 24 mm expanded polytetrafluoroethylene graft were performed. The postoperative course was uneventful and the patient was discharged on the 11th postoperative day.