急性心筋梗塞後左室自由壁破裂に対するsutureless法後に仮性心室瘤を発症した1例

Ventricular Pseudoaneurysm after Sutureless Repair of Postinfarction Free Wall Rupture of the Left Ventricle：Report of a Case

はじめに　左室自由壁破裂は急性心筋梗塞後の致死的な機械的合併症であり，緊急手術が必要である．われわれは，oozing型の左室自由壁破裂に対しsutureless法で救命しえたが，手術から3ヵ月後に仮性心室瘤を発症し再手術を要した症例を経験したので報告する．

We herein report a case of a left ventricular pseudoaneurysm following sutureless repair for left ventricular free wall rupture. A 78-year-old woman underwent emergency sutureless repair for left ventricular free wall rupture following acute myocardial infarction. Three months later, echocardiography revealed an aneurysm in the postero-lateral wall of the left ventricle. The ventricular aneurysm was incised during reoperation, and defect in the left ventricular wall was closed with a bovine pericardial patch. Histopathologically, the aneurysm wall did not contain any myocardium, confirming the diagnosis of pseudoaneurysm. Although sutureless repair is a simple and highly effective method for oozing-type left ventricular free wall rupture, post-procedural pseudoaneurysm can develop both in acute and chronic phases. Consequently, long-term follow-up is mandatory.