日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 33(5): 404-408 (2017)
doi:10.9794/jspccs.33.404

症例報告Case Report

大動脈弓離断症術後遠隔期に発生した胸部大動脈瘤の一例A Case of Thoracic Aortic Aneurysm Years after Repair of Interrupted Aortic Arch

城尾 邦彦1，落合 由恵1，久原 学1，徳永 滋彦1，長友 雄作2，渡邉 まみ江2，宗内 淳2，城尾 邦隆2Kunihiko Joo1, Yoshie Ochiai1, Manabu Hisahara1, Shigehiko Tokunaga1, Yusaku Nagatomo2, Mamie Watanabe2, Jun Muneuchi2, Kunitaka Joo2

1 独立行政法人地域医療機能推進機構九州病院心臓血管外科Department of Cardiovascular Surgery, Japan Community Health Care Organization Kyushu Hospital ◇ Fukuoka, Japan

2 独立行政法人地域医療機能推進機構九州病院小児循環器科Department of Pediatric Cardiology, Japan Community Health Care Organization Kyushu Hospital ◇ Fukuoka, Japan

受付日：2017年6月11日Received: June 11, 2017
受理日：2017年8月25日Accepted: August 25, 2017
発行日：2017年9月1日Published: September 1, 2017
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症例は29歳男性で，出生後，大動脈弓離断症A型，心室中隔欠損症と診断された．5生日に左側開胸でBlalock–Park法による大動脈弓再建術が施行され，吻合部再狭窄に対し1歳時に再度左側開胸でDacronパッチによる狭窄部の拡大形成術を施行した．術後約20年目よりDacronパッチによる拡大形成術部位が瘤化し，最大短径45 mmへ拡大した．3回目の左側開胸手術であったが，大腿静脈–動脈バイパスによる部分体外循環下での大動脈瘤切除および人工血管置換術を施行した．

We present the case of a 29-year-old man who was born with an interrupted aortic arch type A and a ventricular septal defect. At 5 days after birth, he underwent the Blalock–Park aortoplasty through a left thoracotomy. However, when he was one year old, stenosis was noted at the anastomotic site, and the Dacron patch aortoplasty was performed to enlarge the site. Approximately 20 years after the Dacron patch aortoplasty, a thoracic aortic aneurysm was detected at the patch enlargement site which reached a maximum diameter of 45 mm. Although this was the third recurrent left thoracotomy, we successfully performed aneurysmectomy and graft replacement of the thoracic aorta using femorofemoral bypass.

Key words: Blalock–Park procedure; interrupted aortic arch; aortoplasty; thoracic aneurysm

© 2017 特定非営利活動法人日本小児循環器学会© 2017 Japanese Society of Pediatric Cardiology and Cardiac Surgery

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