Abstract
大動脈弁置換術 (AVR) に際し, 選択的冠灌流カニューレによる内膜損傷に起因すると思われる高度左冠動脈入口部狭窄症例に対し冠動脈バイパス術を施行し良好な結果を得た. 症例は, 67歳男性で, AVR後4か月ごろより狭心痛発作が頻発するようになり, 冠動脈造影で左冠動脈入口部に99%狭窄を認めた. 逆行性冠灌流法による心筋保護下, 大伏在静脈グラフトを用い, 左冠動脈前下行枝へのバイパスを行った. 術後経過は順調で, 狭心痛発作は消失した. AVR後早期に狭心痛発作や重症不整脈を認めた場合には, 本症を念頭に置き, 早急な対策が必要である.
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