Valsalva洞動脈瘤破裂に対して二重パッチ閉鎖を施行した1例

Double Patch Closure for Ruptured Sinus of Valsalva Aneurysm：Report of a Case

はじめに　Valsalva洞動脈瘤破裂は，左右シャントによる心不全のため早急に手術となることが多い．病型や合併疾患により治療法は異なるが，破裂部の修復は直接閉鎖や破裂側でのパッチ閉鎖が主体である1）．われわれは右Valsalva洞から右室へ破裂したValsalva洞動脈瘤に対して，二重パッチ閉鎖を行い，良好な結果を得た症例を経験したので報告する．

A 53-year-old man visited a previous hospital because of dyspnea. He was transferred to our hospital with a diagnosis of a ruptured Valsalva aneurysm. At surgery, the tip of aneurysm originated from the right sinus of Valsalva had ruptured into the right ventricular outflow tract. A longitudinal incision was made in the main pulmonary artery, and the rupture site was closed with continuous suture. The first Hemashield patch was sewn to the tissue around the aneurysm in the right ventricular outlet septum. After that, the second Hemashield patch was fixed to the patch of the right ventricular outlet septum by horizontal mattress suture from the aorta. There has been no problem for more than five years after surgery.