抗リン脂質抗体症候群を合併した大動脈弁閉鎖不全症とStanford A型慢性大動脈解離の1例

Aortic Regurgitation and Stanford Type A Aortic Dissection with Antiphospholipid Antibody Syndrome：Report of a Case

はじめに　抗リン脂質抗体症候群（APS）は動脈もしくは静脈の血栓塞栓症をきたす疾患であり，開心術を含むAPSを合併した胸部外科手術においては高い死亡率と合併症率が知られている1）．われわれは，APSを合併した大動脈弁閉鎖不全症（AR）およびStanford A型慢性大動脈解離に対して手術を行った1例を経験したので報告する．

Antiphospholipid antibody syndrome （APS） is associated with high morbidity and mortality resulting from hemorrhagic or thromboembolic events and compromised host immunity due to steroid use. We reported a successful surgery for aortic valve regurgitation （AR） and dissecting aortic aneurysm （DAA） in the ascending aorta in a patient with APS. A 75-year-old woman with AR and primary APS was transferred to our institute because of fever and dyspnea. She was given a diagnosis of pneumonia and congestive heart failure （CHF）. Enhanced computed tomography （CT） incidentally revealed chronic DAA. After medical treatment for CHF and pneumonia, elective surgery to replace the aortic valve and ascending aorta was performed. We paid special caution to intraoperative hemostasis and perioperative anticoagulation management. No adverse event was observed in this patient’s postoperative clinical course, and she was discharged home.