無症候性巨大左心耳瘤の1例

Asymptomatic Left Atrial Appendage Aneurysm：Report of a Case

はじめに　左心耳瘤は非常にまれな疾患であり，小児期を含め若年者では無症状なことが多いが，将来の血栓塞栓症や不整脈発症の予防目的で診断がつき次第手術を行うことが推奨されている1）．

We successfully performed resection of a large asymptomatic left atrial appendage aneurysm （LAAA） under non-cardiac arrest. Although the patient was asymptomatic, chest X-ray showed projection of the third left aortic arch, and computed tomography angiography showed a huge left atrial appendage aneurysm. Therefore, we decided to perform LAAA resection via a partial median sternotomy. Aneurysmectomy was performed by placing the patient on pump beating heart. The size of the resected aneurysm was approximately 80 mm in diameter. Because the base of the LAAA was constricted and the tissue was not fragile, resection was performed using an automatic excision anastomosis device （Echelon Flex）. The patient’s postoperative course was uneventful. Left atrial appendage aneurysm is believed to be congenital；however, it is often detected in adulthood. Long-term follow-up is necessary to ensure maintenance of optimal cardiac function.