成人左冠状動脈肺動脈起始症に対し大動脈-冠状動脈主幹部に人工血管を間置した1 例

A 70-year-old woman with back pain was diagnosed with adult anomalous origin of the left coronary artery from the pulmonary artery ［Bland-White-Garland （BWG） syndrome］. Preoperative transthoracic echocardiography showed diffuse hypokinesia of the left ventricle and mild mitral valve regurgitation. Coronary angiography revealed dilatation of both coronary arteries, but no aneurysms. The left coronary ostium was removed as buttons of the pulmonary arterial wall, and a prosthetic graft （8 mm ePTFE graft） was interposed between the ascending aorta and coronary button. The pulmonary arterial wall was repaired with a bovine pericardium. Postoperative angiography showed good flow of the graft. The antegrade flow provided by this simple technique will allow feasible percutaneous coronary intervention in the future.