緊急冠状動脈バイパス術後に発症した心室中隔穿孔に対する経右室拡大サンドイッチ法の1例

Extended Sandwich Patch Technique through Right Ventriculotomy in Patient with Septal Perforation Developed after Off-Pump Coronary Artery Bypass Grafting；Report of a Case

はじめに　急性心筋梗塞（AMI）後の心室中隔穿孔（VSP）は，現在においても致死的となる心筋梗塞合併症である．われわれは，緊急冠状動脈バイパス術（CABG）後3日目に発症したVSPに対して，経右室拡大サンドイッチ法で救命しえた1例を経験したので報告する．

A 72-year-old diabetic man was diagnosed with acute myocardial infarction of the anterior wall and underwent emergency off-pump coronary artery bypass grafting. He was diagnosed with ventricular septal perforation （VSP） 3 days after the operation. We urgently performed surgical repair of VSP with “extended sandwich patch technique through right ventriculotomy”. There was no shunt recurrence. This technique is considered to offer safe, simple and leak-free repair even in an acute phase of VSP.