瘤径拡大に伴い胸部症状が出現した冠状動脈バイパス術後大伏在静脈グラフト瘤の1例

Gradual Enlargement of Saphenous Vein Graft Aneurysm Causing Chest Symptom after Coronary Artery Bypass Grafting；Report of a Case

はじめに　冠状動脈バイパス術（CABG）後の大伏在静脈グラフト（SVG）瘤はまれな合併症であり，瘤径にかかわらず致死的な合併症をきたすため，早期手術が推奨される．われわれは，他疾患の手術を先行したことで長期の経過観察を要し，瘤径が拡大して胸部症状を呈するにいたった症例を経験したので，報告する．

A 70-year-old man was admitted to our hospital because of shortness of breath. He had undergone coronary artery bypass grafting at another hospital 18 years before. We had detected his saphenous vein graft to the right coronary artery being aneurysmal 3 years before. The aneurysm had grown from 23 mm to 42 mm during the follow-up. Because of an angina-like symptom and the possibility of rupture, we performed resection of the aneurysm and redo coronary artery bypass grafting to the right coronary artery using another saphenous vein. His symptom has disappeared since then. Saphenous vein graft aneurysm needs close follow-up even when conservative therapy is selected.