| Japanese |
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| Title | 大動脈全置換術 |
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| Subtitle | 症例 |
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| Authors | 金子達夫*1, 山田崇之*2, 大林民幸*1, 村井則之*1, 佐藤泰史*1, 尾形敏郎*1 |
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| Authors(kana) | |
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| Organization | *1群馬県立循環器病センター心臓血管外科, *2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 | 590-594 |
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| Year/Month | 1997/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「はじめに」体外循環法の発達と手術手技の進歩により, 大動脈疾患に対する拡大手術は盛んに行われるようになった. 上行から下行まで, あるいは胸腹部の一期的全置換は, もはや珍しいことではない. しかし, 上行から腹部までの全置換術の報告は少なく, 手術適応に関しても過大な侵襲であるとの意見が多い. 著者らはMarfan症候群に合併したDeBakey I型解離のBentall手術後に三腔解離を併発した症例に, 上行から腹部までの一期的大動脈全置換手術を経験したので, 全置換術の可能性と問題点に関して報告する. 「症例」35才, 男性, 身長180cm, 体重51kg 1986年から大動脈弁閉鎖不全と瘤をエコーで指摘されていた. 1987年7月12日DeBakey I型急性解離発症, 7月14日他院にてBentall手術を施行された. 術後, C型肝炎発症と軽度不整脈があったが軽快した. 1994年頃に胸痛があり動脈瘤を指摘されたが, 対症療法で経過した. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Aortic aneurysm, Marfan syndrome, Total replacement of aorta |
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| English |
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| Title | Total Replacement of the Aorta -A Case Report- |
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| Subtitle | |
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| Authors | Tatsuo Kaneko*1, Takashi Yamada*2, Tamiyuki Obayashi*1, Noriyuki Murai*1, Yasushi Sato*1, Toshiro Ogata*1 |
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| Authors(kana) | |
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| Organization | *1Division of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, *2Department of Cardiovascular and Thoracic Surger, Dokkyo University 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 | 590-594 |
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| Year/Month | 1997/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We experienced total replacement of the aorta for a 35 years old man who had underwent Bentall type operation of the aortic root and ascending aorta for 9 years ago. Dissected aorta dilated aneurysmal and new dissection occurred to form triple lumen dissection. He was Marfan syndrome and his heart shifted to the left due to funnel chest. Operation was performed by median so-called "trap door" incision and Stoney's spiral incision. Cardiopulmonary bypass was maintained by femoral perfusion via a artificial graft anastomosed to right common iliac artery and two stage drainage from right atrium. The ascending, transverse and descending aorta was replaced by a branched woven Dacron graft, and thoracoabdominal aorta was reconstructed by using modified DeBakey method. The spinal cord arteries were anastomosed en-block to a bypass graft between descending graft and the perfused graft. Bleeding tendency was uncontrollable after long cardiopulmonary bypass of 433 minutes. He died by low cardiac output two hours later after operation at ICU. |
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| Practice | Basic medicine |
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| Keywords | Aortic aneurysm, Marfan syndrome, Total replacement of aorta |
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