右鎖骨下動脈瘤と感染性心内膜炎に対する同時手術の1例

Open Surgery for Right Subclavian Artery Aneurysm with Infective Endocarditis：Report of a Case

はじめに　鎖骨下動脈瘤は末梢動脈瘤のうち約1％とまれな疾患である1）．われわれは右鎖骨下動脈瘤と感染性心内膜炎に対する同時手術を経験したため報告する．

Subclavian artery aneurysm is usually rare. We report a case of a right subclavian artery aneurysm with infective endocarditis. A 36-year-old woman was admitted at our hospital due to a cerebral embolism. The echocardiogram showed severe mitral regurgitation with vegetation, and computed tomography （CT） revealed an intrathoracic right subclavian artery aneurysm. The 59×39 mm-sized mass was located distal to the vertebral artery. Mitral valvuloplasty, tricuspid annuloplasty, and aneurysm surgery with extra-anatomical bypass were performed simultaneously. The aneurysm was resected through a median sternotomy and right supraclavicular and subclavicular incisions. Revascularization with transthoracic aorto-axillary extra-anatomical bypass was also performed. The postoperative course was uneventful with no noted complications.