大動脈縮窄症術後遠隔期に生じた胸部大動脈瘤破裂に対する胸部大動脈ステントグラフト内挿術の1例

Endovascular Repair for Ruptured Thoracic Aortic Aneurysm Long after Surgery for Coarctation of the Aorta：Report of a Case

はじめに　大動脈縮窄症（CoA）の術後遠隔期に修復部が瘤化する例が報告されている1）．われわれはCoAの術後23年を経て修復部に生じた瘤が破裂したが，血管内治療で救命しえた症例を経験したので報告する．

Previous reports have described cases of aneurysm forming at the repair site of coarctation of the aorta （CoA） decades after initial surgery. We herein report a case of endovascular repair for a ruptured aortic aneurysm that occurred at the repair site of CoA 23 years after the initial surgery. The patient was a 37-year-old man who presented to our hospital for hemoptysis. He previously underwent aortoplasty with direct suture for CoA at the age of 14 years. Computed tomography （CT） revealed a ruptured descending aortic aneurysm with perforation into the left lung；the location of the aneurysm coincided with the site of the previous CoA repair. He underwent emergent thoracic endovascular aortic repair. The postoperative course was uneventful, and the aneurysm was remained stable for over a year after the surgery.