まれな形態を呈した巨大偽性仮性心室瘤の1例

Large Left Ventricular Pseudo-false Aneurysm：Report of a Case

はじめに　心室瘤は心筋梗塞後の重篤な合併症の一つであり，12～15％の確率で発生するとされる1）．中でも偽性仮性心室瘤は非常にまれな疾患であり，仮性瘤の形態を呈しながら梗塞部心筋の裂開が全層に及ばず，心筋組織が一部残存し形成される瘤である2）．われわれは右室方向に屈曲・突出した巨大な偽性仮性心室瘤の症例を経験したので報告する．

A 70-year-old male was diagnosed with a ventricular aneurysm at the apex. The aneurysm was large, measuring 77 mm, so surgery was performed. We performed the operation to prevent rupture and improve low cardiac function, following the septal anterior ventricular exclusion procedure. Postoperative pathological examination revealed that the protruding wall on the right ventricular side consisted of fibrous tissue with sclerosis and a small amount of myocardial tissue, leading to a diagnosis of a pseudo-false aneurysm. Postoperative cardiac function improved, with the ejection fraction （EF） increasing from 24％ to 45％. Left ventricular pseudo-false aneurysm is rare, and we report this case including the review of the literature.