特発性上行大動脈破裂の1例

Spontaneous Rupture of the Ascending Aorta；Report of a Case

はじめに　特発性大動脈破裂は大動脈解離や大動脈瘤，大動脈の外傷を伴わず突然に大動脈壁が破裂する，きわめてまれでかつ予後不良な疾患である．病理組織学的にも動脈硬化性変化を認めない上行大動脈の破裂例を救命しえたので，若干の文献的考察を加えて報告する．

A 66-year-old woman was transferred to our hospital on an emergency basis complaining of a sudden onset of chest discomfort. An emergency contrasted computed tomography showed a ruptured the ascending aorta near the right pulmonary artery with a hematoma and notch in the aortic wall. An emergency operation of the graft replacement was performed via standard median sternotomy under the cardiac arrest with aortic clamp. Upon the operation, there was a 1.5 cm rupture site in the central portion of the ascending aorta. There was no specific evidence of aortic aneurysm or dissection, therefore a spontaneous rupture of the ascending aorta was diagnosis. The pathological finding was normal without pathological changes of cystic medial necrosis or atheroma. The postoperative course was uneventful and he was discharged 14 days after surgery.