急性心筋梗塞を伴った多発冠状動脈瘤に対する1例

Coronary Artery Bypass Grafting for Coronary Aneurysms Causing Acute Myocardial Infarction；Report of a Case

はじめに　冠状動脈瘤は比較的まれな病態であるが，瘤内血栓形成に伴う急性心筋梗塞（AMI）および瘤破裂が臨床上問題となる．冠状動脈瘤の治療ガイドラインは存在しないが，われわれはAMIを起こした多発冠状動脈瘤に対して血栓吸引を行って救命し，その後二期的に冠状動脈バイパス術（CABG）を施行した1例を経験したので報告する．

Coronary aneurysms are relatively rare. However, myocardial infarction associated with thrombus formation in the aneurysm and rupture of the aneurysm are clinical problems. There are no specific guidelines for the treatment of coronary aneurysms. Here, we report a case of a 47-year-old female with acute myocardial infarction. She had a history of collagen disease, which was suspected to be Kawasaki disease. She underwent thrombus aspiration supported by intra-aortic balloon pumping （IABP） because of acute thrombosis of coronary aneurysms, followed by coronary artery bypass grafting on 2 stages. The operative course was uneventful.