膜様部心室中隔瘤パッチ閉鎖を伴う大動脈基部置換術

Aortic Root Replacement with Patch Closure of Membranous Ventricular Septal Aneurysm

膜様部心室中隔瘤（MSA）は心室中隔欠損症（VSD）を合併することが多く，自然閉鎖過程におけるMSA形成が指摘されている．また感染性心内膜炎（IE），虚血および外傷なども原因となる．合併疾患を伴わないMSA単独で手術適応となることはまれであり，成人期のMSAの報告は非常に少ない．

Membranous ventricular septal aneurysm （MSA） complicated with annuloaortic ectasia （AAE） is rare in adults. Herein, we reported two successful surgical cases of this setting. One case is 50-year-old man with extensive infective endocarditis with underwent aortic coarctation repair in childhood. MSA was incidentally diagnosed at preoperative examination. The other patient is 53-year-old man who had severe aortic regurgitation complicated with AAE and membranous type ventricular septal defect with MSA. Simultaneous surgery comprising patch closure of MSA and aortic root replacement was performed in both patients. As for patch closure of MSA, the technical modification should be necessitated according to the fragility of the upper margin of the MSA.