Original Jatene術後遠隔期の左冠状動脈狭窄

Left Coronary Artery Stenosis Long-term After Original Jatene Procedure

完全大血管転位（TGA）に対する動脈スイッチ手術の予後は比較的良好である1，2）が，遠隔期の冠状動脈狭窄には注意を要する3，4）．われわれは新生児期にoriginal Jatene手術を行い，遠隔期に左冠状動脈狭窄をきたした症例に対して再手術を行った．この遠隔期合併症の発生原因と手術術式に関して考察を加えて報告する．

An eight-day-old boy with the transposition of the great arteries （TGA） with posterior aorta underwent original Jatene procedure. He has been developing well. Cardiac catheterization revealed good coronary artery blood flow at five years of age. At the age of 13 years, he had a critical episode of fainting during excessive physical exertion in the junior high school club activities. Three-dimensional computed tomography （CT） revealed a slit-like stenosis of the left coronary artery orifice. Enlargement of the left coronary orifice was successfully performed. Stretching of the left coronary artery into the enlarged aorta may cause the coronary orifice stenosis. The patient is doing well two years after surgery.