Sugimoto Ai, Ohzeki Hajime, Aoki Kenji, Saito Masayuki
Division of Thoracic and Cardiovascular Surgery, Niigata Prefectural Shibata Hospital, 1-2-8 Honcho, Shibata, Niigata, 957-8588, Japan.
Gen Thorac Cardiovasc Surg. 2010 Dec;58(12):630-2. doi: 10.1007/s11748-010-0585-z. Epub 2010 Dec 18.
A 70-year-old woman without any previous history of heart disease was referred to our hospital for repeated chest discomfort. She had experienced temporary hemiparesis because of a cerebral infarction of unknown etiology. Clinical evaluations were all within normal limits except for echocardiography. There was a mobile tumor in her ascending aorta, about 15 mm in diameter, adhering to a part of the right coronary cusp on its aortic side. Urgent surgery was performed. The tumor was attached to the edge of the right coronary cusp and excised with a part of the right coronary cusp, which was then repaired. Histological examination revealed the tumor to be a papillary fibroelastoma. The chest discomfort responsible for admission disappeared after the operation. In patients with events that may be embolic in nature and are not explained by other cardiovascular or neurological diseases, a cardiac source of emboli should be considered.
一名70岁女性，既往无心脏病史，因反复胸部不适转诊至我院。她曾因病因不明的脑梗死出现过短暂性偏瘫。除超声心动图外，各项临床检查均在正常范围内。升主动脉内有一个活动的肿瘤，直径约15毫米，附着于主动脉侧右冠状动脉瓣叶的一部分。遂进行了急诊手术。肿瘤附着于右冠状动脉瓣叶边缘，连同部分右冠状动脉瓣叶一并切除，随后进行修复。组织学检查显示肿瘤为乳头状纤维弹性瘤。术后导致入院的胸部不适消失。对于具有可能为栓塞性质且无法用其他心血管或神经系统疾病解释的事件的患者，应考虑心脏栓子来源。
