左冠状動脈起始異常に対しunroofing法を施行した1例

Unroofing Technique on Anomalous Aortic Origin of a Left Coronary Artery；Report of a Case

はじめに　冠状動脈起始異常は，若年者の突然死の原因の一つとして知られている1）．日常的に症状が出ないことがほとんどであり，不整脈や心停止を起こし，その際の検査で発見されることも多い2）．われわれは，サッカーの試合中に胸痛および意識障害を起こして発見された，大動脈壁内走行を合併した左冠状動脈起始異常に対し，unroofing法を施行した症例を経験したので報告する．

An anomalous aortic origin of coronary artery is a cause of sudden death in young people. We report a surgical case of an anomalous aortic origin of the left coronary artery. A 16-year-old man with chest pain, which occurred while playing football, was taken in an ambulance. Electrocardiogram （ECG） revealed an ST-segment elevation in V1-V5. We performed coronary angiogram （CAG） and detected the anomalous aortic origin of left anterior descending artery. The computer tomography （CT） angiography revealed the intramural pathway of the left coronary artery. Surgery performed as an unroofing procedure for releasing the intramural portion of the left coronary artery. We confirmed a dilation of the left coronary artery ostia in postoperative coronary CT angiography. He did not have chest pain and other symptoms while cardiopulmonary exercise testing. He was discharged on the 18th postoperative day. He is seen as an outpatient without any symptoms.