心筋梗塞後の偽性仮性心室瘤破裂

Rupture of Left Ventricular Pseudo-false Aneurysm after Myocardial Infarction

偽性仮性心室瘤1）は非常にまれな心筋梗塞後合併症である．われわれは，心筋梗塞亜急性期に偽性仮性心室瘤の形成と破裂をきたした症例に対し，緊急手術を行い救命しえたので報告する．

We herein present a case of ruptured left ventriclular pseudo-false aneurysm. A 73-year-old female had acute myocardial infarction due to occlusion of the left circumflex artery, and subsequently underwent percutaneous coronary intervention. Three weeks later, however, the patient suddenly fell into a state of shock. Contrast-enhanced computed tomography （CT） revealed rupture of left ventricular aneurysm, and emergency surgery was performed. A ruptured aneurysm was observed in the posterior wall, and as the wall of the aneurysm was fragile, it was repaired using double-patch technique. Histopathological examination revealed myocardial cells in the aneurysm wall, confirming diagnosis of pseudo-false aneurysm. Pseudo-false aneurysm is a rare type of left ventricular aneurysm. In cases of rupture in acute or subacute phase of myocardial infarction, when the aneurysm wall is fragile, double-patch repair technique effectively ensures hemostasis and prevents future aneurysm formation.