冠状動脈瘻を合併した冠状動脈瘤破裂の1例

Rupture of Coronary Artery Aneurysm with Coronary Artery to Pulmonary Artery Fistula；Report of a Case

はじめに　冠状動脈瘻を合併した冠状動脈瘤破裂はきわめてまれな疾患であり，われわれは交通動脈でつながる二つの冠状動脈瘤破裂の症例を報告する．

We report a rare case of ruptured coronary artery aneurysm. A 58-year-old woman experienced a sudden chest pain. Coronary arteriography （CAG） and computed tomography （CT） showed pericardial effusion and 2 saccular coronary artery aneurysms connected by a communicating artery. The 1st one was originated from the right coronary artery and flowed to the communicating artery. The 2nd one was originated from both the diagonal branch and the communicating artery, and flowed to the main pulmonary artery, forming a fistula. Since the 1st one was larger, it was suspected to be the rupture site. Emergency operation was performed and the aneurysms were directly closed under cardiopulmonary bypass. The postoperative course was uneventful.