偶発的に診断された瘤化を伴う先天性左内胸動脈-肺動脈瘻の1例

Congenital Left Internal Mammary Artery to Pulmonary Artery Fistula with Aneurysmal Change Diagnosed Incidentally：Report of a Case

はじめに　内胸動脈-肺動脈瘻はまれな疾患であり，外傷や炎症，感染，手術後など，後天的なものが多いといわれている．対して，先天的な内胸動脈-肺動脈瘻は非常にまれでまとまった報告がほとんどなく，その病態や治療方針などに関して十分な知見がない．われわれは，偶発的に診断された先天性左内胸動脈-肺動脈瘻の1例を経験したので報告する．

An internal mammary artery to pulmonary artery （IMA-PA） fistula is a very rare vascular abnormality. Patients with this disease are often asymptomatic, but they may develop symptoms such as heart failure and hemoptysis. A 60-year-old woman was incidentally diagnosed with left IMA-PA fistula by chest computed tomography （CT） during an examination for colon cancer. She was asymptomatic, but we determined that surgery was indicated because of the presence of an aneurysmal change. We performed complete surgical resection of the IMA-PA fistula and aneurysm under cardiopulmonary bypass. Her postoperative course was uneventful. Although a specific management strategy for IMA-PA fistula has not yet been established, surgical treatment should be performed to prevent rupture in cases with aneurysmal change.