| Japanese |
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| Title | DeBakey III型解離牲大動脈瘤の手術成績 |
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| Subtitle | 原著 |
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| Authors | 今関隆雄, 入江嘉仁, 片山康, 長澤城幸, 垣伸明, 佐藤康広, 秦一剋, 山田崇之 |
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| Organization | 獨協医科大学越谷病院心臓血管外科 |
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| Journal | 循環制御 |
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| Volume | 18 |
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| Number | 4 |
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| Page | 548-554 |
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| Year/Month | 1997/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」1985年10月から1996年11月までに42例のDeBakey III型解離性大動脈瘤が当科で治療を受けた. DeBakey III型は一般的には保存的に治療されることが多いが, 42例中21例(24手術)が外科的に対処された(病院死亡5例, 23%). 手術適応がないと判断された経過観察症例は21例平均年齢62.2歳(男性13例, 女性8例)であった(病院死亡3例, 14%). 手術適応となった症例は21例平均年齢54歳(男性18例, 女性3例)であった. 緊急手術は4例に行われた. 緊急手術適応は瘤破裂(3例)腹部臓器及び下肢虚血(1例)の4例(死亡3例)であり, 待機手術の適応は瘤径の拡大(50mm以上, 12手術), 準緊急手術の適応はUlcer like projection(ULP)(1例)であった. 外科治療適応群21例中12例(60%)が1年以内に手術を受けた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | DeBakey type III dissection, Surgical indication, Thoracoabdominal replacement, Replacement of descending aorta, Paraplegia |
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| English |
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| Title | Surgical Treatment for DeBakey Type III Dissection |
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| Authors | Takao Imazeki, Yoshihito Irie, Yasushi Katayama, Shiroyuki Nagasawa, Nobuaki Kaki, Yasuhiro Sato, Ikkoku Hata, Takashi Yamada |
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| Authors(kana) | |
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| Organization | Department of Cardiovascular Surgery, Dokkyo University School of Medicine, Koshigaya Hospital |
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| Journal | Circulation Control |
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| Volume | 18 |
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| Number | 4 |
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| Page | 548-554 |
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| Year/Month | 1997/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Forty-two patients were diagnosed as a DeBakey type III dissection and treated between 1985 and 1996 in our department. Twenty one patients underwent surgical treatment. Follow-up C-T scan with contrast, angiographycal tests or a combination of these tests was available in all patients with preoperatively. Operative indication were as follows : (1) when the maximal size of aneurysm was larger than 50mm, (2) when ulcer like projection was diagnosed, (3) when any ischemia of the abdominal organ or lower extremities were diagnosed. Eight patients underwent thoracoabdominal replacement (mortality is 25% : n=2, emergency), fourteen patients underwent replacement of descending aorta (mortality is 21% : n=3 emergency 1). Patient and operation-related variables are age (mean 54.6 years range 30 to 79), sex (86% men), rupture (14%, 3), ulp (5%, 1), ischemia of abdominal organs (5%, 1). Hospital mortality is 23% (n=5, three emergency operation). Spinal cord dysfunction (paraplegia) was not seen. When we performed the emergent surgery, the mortality was higher than the elective surgery. |
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| Practice | Basic medicine |
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| Keywords | DeBakey type III dissection, Surgical indication, Thoracoabdominal replacement, Replacement of descending aorta, Paraplegia |
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