巨大冠状動脈瘤を伴う冠状動脈肺動脈瘻の1例

Surgical Repair of Giant Coronary Artery Aneurysm Associated with Coronary-pulmonary Artery Fistulae；Report of a Case

はじめに　冠状動脈肺動脈瘻に冠状動脈瘤を合併する症例は比較的まれである1，2）．冠状動脈瘤の破裂により心タンポナーデをきたした症例も報告されており，手術のタイミングは重要である3，4）．われわれは，巨大冠状動脈瘤を伴う冠状動脈肺動脈瘻に対する1手術例を経験したので報告する．

A 61-year-old woman was referred to our hospital with a complaint of chest compression. Coronary angiography revealed a giant coronary artery aneurysm, located in the middle of a coronary-pulmonary artery fistula originating from the right coronary artery. Another fistula was also shown between the left anterior descending artery and the pulmonary artery. Surgical correction was indicated due to the risks of the aneurysmal rupture and coronary events. Under cardiopulmonary bypass, suture-closure of the coronary artery aneurysm and ligations of the fistulae were carried. Postoperative coronary angiography showed no aneurysm or fistula, and she was discharged uneventfully on the 12th postoperative day.