肺高血圧を有する単心室に生じた肺動脈解離に対して肺動脈人工血管置換を施行した1例

Pulmonary Artery Replacement in a Patient with Pulmonary Artery Dissection Associated with Pulmonary Hypertension and Single Ventricle：Report of a Case

はじめに　肺動脈解離（PAD）は，肺動脈瘤（PAA）や肺高血圧（PH）に続発することが多く，予後不良である．

A right-sided classical Blalock-Taussig shunt was created in a 3-year-old male infant with hypoplastic left ventricle, common atrioventricular valve, transposition of the great arteries, and pulmonary stenosis. He was diagnosed with near Eisenmenger pulmonary hypertension at the age of 6 years. Surgery to achieve right heart bypass circulation was not conducted. At 33 years of age, he experienced hemoptysis.

Pulmonary artery dissection, a life-threatening condition, was detected upon computed tomography performed when the patient was 35 years of age. After three weeks, surgery with cardiopulmonary bypass requiring pulmonary artery replacement using composite prosthetic conduits, closure of the pulmonary valve, and banding of the previously created Blalock-Taussig shunt was performed. Six years after the surgery, the patient’s physical activity is maintained. Although intracardiac repair or definitive palliation with cardiopulmonary bypass is contraindicated in such patients, life-saving surgery with cardiopulmonary bypass that does not worsen pulmonary hypertension can be performed.