大動脈弁置換術後19年で巨大大動脈基部瘤をきたした1例

A Huge Aortic Root Aneurysm Nineteen Years After Aortic Valve Replacement：Report of a Case

はじめに　大動脈弁置換術後の遠隔期大動脈基部拡大が報告されている．その原因として，二尖弁，大動脈解離，Marfan症候群，組織異常疾患，高安動脈炎，弁置換術時より基部拡大しているものがあげられる．

We report a case of huge aortic root aneurysm 19 years after aortic valve replacement. A 58-year-old woman was referred to us for aortic root dilatation. She underwent aortic valve replacement with mechanical valve due to severe aortic regurgitation of tricuspid aortic valve 19 years ago. We performed graft replacement of aortic root preserving prior mechanical prosthetic valve. Histological examination of aneurysm showed myxomatous change in medial layer. Aortic root dilatation after aortic valve replacement is caused by bicuspid valve, aortic dissection, Marfan syndrome, tissue disorder disease, aortitis, and dilated Valsalva sinus at the time of prior operation. It is important to follow-up a patient for root dilatation after aortic valve replacement.