特発性左室心尖部瘤の成人例に対する外科治療の1例

Idiopathic Aneurysm at Left Ventricular Apex in an Adult：Report of a Case

はじめに　明らかな原因が認められない心室瘤を先天性と分類することには問題が残るとされており，特発性心室瘤と診断するのが妥当であるとの報告がある1）．われわれは仮性瘤が疑われて当院に紹介され，精査の結果，原因不明と考えられた左室瘤に対する手術例を経験したので報告する．

A 69-year-old woman was referred to our hospital because of a probable false aneurysm measuring 16 mm at the left ventricular apex. She had received no anti-cancer agents. She had no history of angina pectoris, myocardial infarction, myocarditis, or cardiac sarcoidosis. Imaging study showed no evidence of obstructive coronary artery disease. Magnetic resonance imaging demonstrated no systolic motion of the aneurysm. Therefore, etiology was unknown, but idiopathic aneurysm was most likely. She underwent surgical resection of the aneurysm and linear closure. Histologic examination of the base of the aneurysm showed significant edema and fibrosis of degenerative myocardium. Because specimen of the tip or free wall of aneurysm was not obtained, false or pseudo-false aneurysm and congenital ventricular diverticulum could not be ruled out. Her cardiac function remained good for 4 years.