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はじめに 多発血管炎性肉芽腫症(granulomatosis with polyangiitis:GPA)は上気道,肺,腎臓の肉芽腫性壊死を特徴とする血管炎である.血管炎の主座は中型~小型の動静脈および毛細血管であり,大血管病変はまれである.われわれはGPAを既往に有する患者の上行大動脈瘤,僧帽弁閉鎖不全症の手術症例を経験したので報告する.
The patient is a 63-year-old man with a history of granulomatosis with polyangiitis (GPA). More than 10 years after the diagnosis of GPA and its remission, he was taken to the emergency room with the chief complaint of palpitation and dyspnea, and was referred to our department for surgery of aggravated mitral regurgitation. An ascending aortic aneurysm was incidentally disclosed during preoperative examinations. He underwent ascending aorta replacement, mitral valve replacement, and left side maze operation. Pathological findings of the aortic aneurysm wall were compatible with GPA. Although large vessels are rarely affected by GPA, patients with a history of GPA need regular cardiovascular follow-up even after remission.
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