乳頭状線維弾性腫による急性冠症候群の1例

Acute Coronary Syndrome Caused by Papillary Fibroelastoma：Report of a Case

はじめに　乳頭状線維弾性腫（papillary fibroelastoma：PFE）は心臓原発の良性腫瘍で，弁膜に発生する腫瘍ではもっとも多く，大動脈弁に好発する．右冠尖に発生したPFEにより急性冠症候群（acute coronary syndrome：ACS）を呈し，冠状動脈血管内治療後に緊急手術を行った症例を経験したので報告する．

A 72-year-old female had persistent severe chest pain while climbing stairs. She was diagnosed as having acute coronary syndrome, and underwent an emergency coronary angiography （CAG）. The right coronary artery （RCA） ostium was sub-totally occluded. Echocardiography revealed a 10 mm mobile mass at the right coronary cusp of the aortic valve. To avoid total obustruction on two drug eluting stents were placed at the RCA ostium so as to have the proximal end protrude into the right Valsalva sinus. Thus, her hemodynamic condition was stabilized. The tumor was surgically resected and the stents were easily removed. Pathologically, the tumor was papillary fibroelastoma. Postoperative aortic regurgitation was minimal echocardiography, and CAG showed normal RCA.