動脈管開存閉鎖術後遠隔期の囊状瘤に対して1デブランチ胸部ステントグラフト内挿術を施行した1例

One Debranch Thoracic Endovascular Aortic Repair for Saccular Aortic Aneurysm in the Long Term of Ductus Arteriosus Closure

はじめに　動脈管開存の多くは新生児期から乳児期に閉鎖術が行われ，術後予後は一般に良好とされる．このため生涯にわたる経過観察はなされずに成人する例が多いと思われる．われわれは，動脈管閉鎖術後，遠隔期に大動脈弓小彎側の囊状瘤を呈し，ステントグラフト内挿術によって治療した成人例を経験したため報告する．

We present the case of 60s male who underwent ductus arteriosus closure at the age of 10. He presented with hoarseness and a 25 mm-sized saccular aortic aneurysm was identified at the site of the closed ductus through the computed tomography （CT）. The patient successfully underwent 1-debranch thoracic endovascular aortic repair resulting in improved hoarseness. While rare, several reports have documented aneurysm formation long after ductus arteriosus closure. Recent studies highlight favorable outcomes with endovascular repair. Despite its rarity, aneurysmal formation after ductus closure remains a serious complication. Given the increasing population of patients with prior ductus arteriosus closure and the discontinuation of long-term follow-up, awareness of the complication of aneurysmal formation is crucial. Not only congenital cardiologists but also general physicians should consider this differential diagnosis for patients presenting with symptoms such as hoarseness or back pain and a history of ductus closure.