急性心筋梗塞を合併した巨大右冠状動脈瘤の1例

Giant Right Coronary Artery Aneurysm Complicated by Acute Myocardial Infarction：Report of a Case

はじめに　冠状動脈瘤は1812年にBourgonによりはじめて報告された1～4）．疫学的に冠状動脈瘤は非常にまれな疾患であり，心臓カテーテル検査を行った患者の0.3～5％にみられ2，3，5～8），男性に多いと報告されている3，6）．われわれは，心筋梗塞を合併した巨大右冠状動脈瘤に対し，従来もっともよく行われている術式に加え，大動脈基部の剝離を行い，瘤が存在した冠状動脈血流を起始部で遮断した症例を経験したので，報告する．

The patient was a 45-year-old man who was transported by ambulance to a nearby clinic owing to sudden chest pain. He was diagnosed with myocardial infarction and giant coronary artery aneurysm by coronary arteriogram and underwent an emergency intervention for the myocardial infarction. The patient was referred to our hospital. Intraoperative findings showed the mass-like right coronary artery aneurysm at the anterior to the right atrium. The origin of the right coronary artery was ligated in addition to the fenestration and the proximal and distal regions of the coronary artery aneurysm. It has been reported that coronary artery aneurysms are usually asymptomatic and are often discovered by chance during screenings, such as echocardiography, computed tomography, and coronary arteriogram. Here, we report a surgical case of giant right coronary artery aneurysm complicated by acute myocardial infarction.