高齢者に対する心肺同時手術の1例

Concomitant Cardiac and Pulmonary Operation on an Elderly Patient：Report of a Case

はじめに　高齢化社会を迎え，高齢者の心臓手術は増加傾向にあり，なかには悪性腫瘍の合併もみられる．その際は，心臓疾患の重症度や悪性腫瘍の病期に考慮する必要がある．われわれは，狭心症を伴う大動脈弁狭窄症の高齢者の肺癌合併例に，同時手術を行ったので報告する．

An 83-year-old woman was admitted because of dyspnea. Transthoracic echocardiography revealed severe aortic valve stenosis with a systolic gradient of 105 mmHg. Coronary angiography showed 75％ stenosis at segment 1. Computed tomography （CT） of the chest revealed a mass, of 15 mm in diameter, in the right segment 1 of the lung. She was diagnosed with severe aortic valve stenosis, right coronary artery stenosis, and a lung tumor suspected to be lung cancer. We performed right lobe partial resection, aortic valve replacement and coronary artery bypass grafting through a median sternotomy. The tumor was diagnosed as adenocarcinoma by pathological examination. The postoperative course was uneventful, and she was discharged three weeks after the operation.