低酸素血症の著明な改善を得た肺動静脈瘻の1手術例  [in Japanese] A surgically treated case of marked hypoxemia caused by pulmonary arterio-venous fistula  [in Japanese]

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Abstract

症例は66歳,女性.主訴はチアノーゼ.他疾患治療中にチアノーゼを指摘され当院紹介となった.胸部造影CT検査では右下肺静脈へ直接流入する右A<SUP>8</SUP>に加え右S<SUP>6</SUP>胸膜直下に拡張した動静脈を認めた.肺動脈造影検査では右A<SUP>8</SUP>から左房へのシャント血流を認めた.肺血流シンチでは肺外臓器への核種分布が確認され,右左シャントの存在は明らかでありシャント率は42%と計算された.以上より多発肺動静脈瘻と診断し右下葉切除術を行った.術前に45.0mmHgであった動脈血酸素分圧が術後には90.6mmHgと著明なる改善を認めるなど術後経過は良好であり,19病日に退院した.

The patient was a 66-year-old female. In the course of therapy for compression fracture, cyanosis was pointed out. Chest CT scan revealed abnormal vessels in the right S<SUP>6</SUP> sub-pleura and the direct connection between the right A<SUP>8</SUP> and right inferior pulmonary vein. Pulmonary angiography showed shunt flow into the atrium. Perfusion scintigraphy revealed extrapulmonary activity due to the right-to-left shunt and a high-level shunt ratio. The diagnosis of pulmonary arterio-venous fistula was made on the basis of these findings. A right lower lobectomy was performed via video-assisted thoracic surgery. Severe hypoxemia was improved after surgery. The postoperative course was uneventful, and the patient was discharged on the 19<SUP>th</SUP> POD.

Journal

  • The Journal of the Japanese Association for Chest Surgery

    The Journal of the Japanese Association for Chest Surgery 22(6), 953-956, 2008-09-15

    The Japanese Association for Chest Surgery

References:  12

Codes

  • NII Article ID (NAID)
    110006951798
  • NII NACSIS-CAT ID (NCID)
    AN10467885
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    09190945
  • Data Source
    CJP  NII-ELS  IR  J-STAGE 
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