大動脈弓下腕頭静脈走行異常を伴った急性大動脈解離の1例

Surgical Repair of Stanford Type A Acute Aortic Dissection Associated with Anomalous Retroaortic Left Brachiocephalic Vein；Report of a Case

はじめに　大動脈弓下腕頭静脈走行異常はまれな疾患であり，急性大動脈解離を伴ったものはさらにまれである．われわれは本例に対して緊急手術を施行し，良好な結果を得たので，若干の文献的考察を加えて報告する．

Anomalous retroaortic left brachiocephalic vein （ARLBV） is a rare vascular abnormaly, usually asossiated with congenital heart diseases. We present a very rare case of Stanford type A acute aortic dissection associated with ARLBV. A 70-year-old man was referred to our hospital complaining of worsening back pain and chest pain. Computed tomographic angiogram showed Stanford type A acute aortic dissection from the ascending aorta to the distal abdominal aorta. Furthermore, systemic venous anomalies were revealed. The left brachiocephalic vein coursed the left side of the aortic arch, anterior to the central pulmonary artery, and posterior to the ascending aorta, and joined the right brachiocephalic vein. Replacement of the ascending aorta was performed in an emergency, and the postoperative course was uneventful.