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はじめに 急性心筋梗塞(acute myocardial infarction:AMI)の合併症である心室中隔穿孔(ventricular septal rupture:VSR)と左室瘤の合併例に対する手術報告例は限られている.われわれは両者の合併例に対してVSR閉鎖術と左室形成術を同時に施行した症例を経験したので,これまでの報告例を含めて術式選択について考察する.
A 70-year-old man with acute myocardial infarction underwent percutaneous coronary intervention (PCI) for the diagonal branch. Eight days after PCI, the patient presented worsening heart failure. Transthoracic echocardiography (TTE) and enhanced computed tomography (CT) revealed ventricular septal rupture (VSR) and left ventricular aneurysm (LVA). After establishing cardiopulmonary bypass, the LVA was longitudinally excised along the left anterior descending artery (LAD). A septal anterior ventricular exclusion (SAVE) procedure was performed using a bovine pericardial patch to exclude the LVA and VSR. The VSR was directly closed with pledgeted sutures. Additionally, coronary artery bypass grafting was performed to the LAD using the left internal thoracic artery. The patient was discharged without any complications.

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