たこつぼ型心筋症後に発症した左室瘤に対する左室形成術

Left Ventricular Plasty for Left Ventricular Aneurysm Following Takotsubo Cardiomyopathy

たこつぼ型心筋症は，急性発症の左室心尖部無収縮を呈する予後良好な疾患である．しかし，一部で心破裂などの致死的合併症を発症する症例もある．われわれは，たこつぼ型心筋症経過中に発症した左室瘤に対して左室形成術を施行し，良好な結果を得たので報告する．

An 82-years-old woman was admitted with sudden chest pain. Coronary angiography did not reveal any significant stenosis, but left ventriculography showed akinesis and ballooning of the apex with a hyperkinetic basal segment, suggestive of takotsubo cardiomyopathy. She suffered intractable heart failure, and laboratory data, electrocardiogram signs of ST-segment elevation and left ventricular （LV） apical dysfunction failed to show improvement. LV plasty was performed on 106th day after the onset because of aneurysmal change of the left ventricular apex myocardium, unremitting sanguineous pericardial effusion, and anemia. She had a good postoperative course and end-diastolic ventricular volume index was remarkably reduced from 144 to 55 ml/m2. She discharged home on the 38th postoperative day.