| Japanese |
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| Title | 破裂性腹部大動脈瘤を合併したStanford A型急性大動脈解離の同時手術例の経験 |
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| Subtitle | 症例 |
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| Authors | 垣伸明, 入江嘉仁, 佐藤康広, 秦一剋, 吉田浩紹, 権重好, 齋藤政仁, 汐口壮一, 岡田修一, 長磨美子, 今関隆雄 |
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| Authors(kana) | |
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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 | 26 |
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| Number | 1 |
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| Page | 50-53 |
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| Year/Month | 2005/3 |
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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 | Stanford A型急性大動脈解離(A型急性解離)に破裂性腹部大動脈瘤を合併した症例の緊急の一期的同時手術を経験した. 症例は75歳男性で, A型急性解離を発症したが放置, 2日後に腹部大動脈瘤が破裂し, ショック症状に陥り当院入院となった. 来院時には, 両側足趾に壊死も認めた. 手術は超低体温循環停止下に上行大動脈と腹部大動脈を同時に置換した. 体外循環からの離脱や止血は共に良好で, 集中治療室に帰室した. 第1病日には右下腿の壊死が進行し, 切断した. 第2病日には左下腿の壊死が進行し, 切断を考慮したが家族の承諾が得られず, 多臓器不全より死亡した. 緊急の重複大動脈手術に対する手術戦略上の問題や過大侵襲に伴う周術期の合併症対策(特に虚血肢対策)などの問題があり報告する. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Stanford A-type acute aortic dissection, ruptured abdominal aortic aneurysm |
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| English |
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| Title | A Case of Concurrent Operations for Stanford A-Type Acute Aortic Dissection and Ruptured Abdominal Aortic Aneurysm |
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| Subtitle | |
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| Authors | Nobuaki Kaki, Kihito Irie, Yasuhiro Satoh, Ikkoku Hata, Hirotugu Yoshida, Shigeyoshi Gon, Masahito Saito, Souichi Shioguchi, Shuichi Okada, Mamiko Cho, Takao Imazeki |
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| Authors(kana) | |
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| Organization | Department of Cardiovascular Surgery, Koshigaya Hospital, Dokkyo University, School of Medicine
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| Journal | Circulation Control |
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| Volume | 26 |
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| Number | 1 |
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| Page | 50-53 |
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| Year/Month | 2005/3 |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We experienced a case of emergent concurrent operations for Stanford A-type acute aortic dissection and ruptured abdominal aortic aneurysm. Two days after the onset of Stanford A-type acute aortic dissection, a 75-year-old male patient was hospitalized in our institution due to circulatory shock caused by ruptured abdominal aortic aneurysm. At admission, necrosis was observed in the toes of both sides. Concurrent operations for the replacements of the ascending aorta and abdominal aorta were uneventfully performed under deep hypothermia and circulatory arrest. Since the necrosis of the right lower leg was exacerbated, the surgical amputation was performed on the first postoperative day. The amputation of the left lower leg was also considered, because of the considerable exacerbation of the necrosis, but his family refused it and he died on the second post-operative day. |
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| Practice | Basic medicine |
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| Keywords | Stanford A-type acute aortic dissection, ruptured abdominal aortic aneurysm |
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