1 昭和大学横浜市北部病院循環器センターCardiovascular Center, Showa University Northern Yokohama Hospital
2 昭和大学横浜市北部病院こどもセンターChildren’s Medical Center, Showa University Northern Yokohama Hospital
第5大動脈弓遺残に合併した大動脈縮窄に対して，カテーテル治療は選択肢となり得るがその報告は少ない．本症例は14歳の男児で第4, 第5大動脈弓が近位部と遠位部で接続する“Double-Lumen Aortic Arch”を呈する第5大動脈弓遺残で，第4大動脈弓の大動脈縮窄を合併していた．大動脈弓は軽度の低形成で，縮窄部と合わせて上行–下行大動脈間に25 mmHgの圧較差を認めた．第4大動脈弓の縮窄部にPalmaz extra-largeステントの留置を行い，狭窄部は良好に拡大され第5大動脈弓の血流は消失した．第5大動脈弓遺残を合併した第4大動脈弓縮窄の未手術例に対してステントの留置が有効であった症例を報告する．
Coarctation of the aorta complicated by persistent fifth aortic arch can be a candidate for catheter intervention. However, there is a paucity of reports on catheter intervention for this anomaly. We report stenting for 14 year-old boy with coarctation of the aorta in fourth arch complicated by persistent fifth aortic arch. This case shows the “double-lumen aortic arch” which had the narrowing at the distal of fourth arch as a main lumen and small fifth arch with narrowing at the distal communication. Transverse arch was slightly hypoplastic, while there was a pressure gradient of 25 mmHg between ascending and descending aorta. We implanted Palmaz extra-large stent in coarctation of the fourth aortic arch. The narrowing was successfully treated and the additional blood flow of fifth arch was disappeared.
キーワード：第5大動脈弓遺残；大動脈縮窄；ステント；カテーテル治療；Palmaz extra-large stent
Key words: Persistent fifth aortic arch; Coarctation of the aorta; Stent; Catheter intervention; Palmaz extra-large stent
© 2016 日本Pediatric Interventional Cardiology学会© 2016 Japanese Society of Pediatric Interventional Cardiology
This page was created on 2016-06-08T11:18:24.916+09:00
This page was last modified on 2016-08-25T16:09:18.384+09:00
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