急性冠症候群をきたした巨大冠状動脈瘤の1例

Acute Coronary Syndrome in a Patient with Giant Coronary Artery Aneurysm：Report of a Case

はじめに　冠状動脈瘤は多くは無症状で経過し，冠状動脈造影（coronary angiography：CAG）施行例の0.3〜4.9％にみられるとされる比較的まれな病態である1，2）．一方で，冠状動脈瘤に関するガイドラインおよび外科的治療に関する一定の見解は存在しない3）．

Coronary artery aneurysm is a rare entity defined as expansion more than 1.5 times of normal coronary artery in diameter. A 77-year-old male was admitted to our hospital with a diagnosis of acute coronary syndrome and a giant right coronary artery aneurysm. Coronary angiography showed occlusion of the right coronary artery and significant stenosis of left anterior descending artery and left circumflex artery. Enhanced computed tomography （CT） showed a right coronary artery aneurysm with a diameter of 38 mm. Urgent coronary artery bypass grafting and coronary artery ligation proximal and distal to the aneurysm were performed. His postoperative course was uneventful.