重症大動脈弁狭窄症に対し経カテーテル的大動脈弁置換術を施行し子宮頸がんが急速に進行し死亡に至った患者の麻酔経験

Rapid Progression of Cervical Carcinoma Resulting in Death following Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis：A Case Report

要旨

　87歳，女性の重症大動脈弁狭窄症に対して，経カテーテル的大動脈弁置換術を緊急で行った。既往症として1年半前に子宮頸がんⅠ期の診断であったが，術前に遠隔転移も認めず，予後は1年以上あると判断された。術後6カ月後に多発肺転移を認め，予想外に急速な子宮頸がん進行を認め死亡に至った。

　An aging society and increased life expectancies make severe aortic stenosis more common. The number of patients with valvular disease and concurrent malignant disease is also on the rise. We performed transcatheter aortic valve implantation（TAVI）on a patient with early stage cervical carcinoma. Following TAVI, the patient’s cancer progressed rapidly and led to death. The treatment of severe aortic stenosis in patients with cancer requires an individualized approach, and should involve a careful decision-making process by the heart team in consultation with oncology specialists to evaluate cancer staging and prognosis.