高安動脈炎に対するOPCAB施行5年後に発症したStanford A型急性大動脈解離

Stanford Type A Acute Aortic Dissection with Severely Calcified Aorta Five Years After Off-pump Coronary Artery Bypass Grafting for Takayasu’s Arteritis

大動脈に高度石灰化を伴う高安動脈炎（TA）に対する心拍動下冠状動脈バイパス術（OPCAB）施行5年後にStanford A型急性大動脈解離を発症したため，大動脈基部および弓部大動脈置換術を施行した症例を経験した．Stanford A型大動脈解離を合併したTAの手術例はまれであり，文献的考察を加えて報告する．

Stanford type A aortic dissection complicated with Takayasu’s arteritis is markedly rare. We report a 68-years-old man with Stanford type A acute aortic dissection. He had undergone off-pump coronary artery bypass grafting （OPCAB） for ostial stenoses of the left and right coronary arteritis complicated by Takayasu’s arteritis 5 years before. The thoracic and abdominal aorta was severely calcified. We performed emergency aortic root placement with a valved conduit as well as total arch replacement. The postoperative course was uneventful, and postoperative computed tomography （CT） showed no pseudoaneurysm formation.