Cabrol手術後28年目に右冠状動脈への人工血管の狭窄をきたした1例

Stenosis of the Right Coronary Limb of Interposed Artificial Graft 28 Years After Cabrol Technique；Report of a Case

はじめに　大動脈弁閉鎖不全（AR）を伴う大動脈基部拡大に対する術式として，1968年にBentall手術が発表された1）．その後種々の変法2～4）が発表され，それぞれの遠隔期合併症に関する報告が散見されるようになった．われわれはBentall手術変法の一つであるCabrol手術後28年目に右冠状動脈（RCA）へのグラフト内狭窄をきたした1例を経験したので報告する．

Cabrol technique is one of the modified Bentall procedures. However, it has become nearly obsolete over the years because of reports of stenosis, thrombosis, and occlusion of the interposed graft. A 76-year-old man, who had undergone Cabrol technique 28 years before, presented with worsening exertional dyspnea and, was diagnosed with mitral valve regurgitation and tricuspid valve regurgitation. Preoperative angiography revealed stenosis of the right limb of the interposed artificial graft, and he underwent coronary artery bypass grafting （CABG） in addition to mitral valve replacement （MVR） and tricuspid annuloplasty （TAP）. Patients who underwent procedures such as Cabrol technique and Piehler technique using interposed artificial grafts reconstructing coronary arteries, should be regularly checked with imaging examinations.