| Japanese |
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| Title | B型解離を合併した腎移植後患者に対する腹部大動脈人工血管置換術：移植腎を温存しえた1例 |
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| Subtitle | 症例 |
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| Authors | 梅津健太郎*, 斎藤聡*, 西中知博*, 石田英樹**, 田邉一成**, 黒澤博身* |
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| Authors(kana) | |
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| Organization | *東京女子医科大学心臓血管外科, **東京女子医科大学泌尿器科 |
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| Journal | 循環制御 |
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| Volume | 29 |
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| Number | 2 |
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| Page | 163-166 |
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| Year/Month | 2008/9 |
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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」生体腎移植の良好な成績により, 生体腎移植後患者の大動脈疾患の合併が増加している1). なかでも, 生体腎移植患者に対する腹部大動脈瘤手術は, 大動脈遮断中の腎保護や, 血行再建の方法など術式の工夫を要するため, いまだ外科手術にとって大きな挑戦である. 今回我々は, B型大動脈解離を合併した腎移植後患者に対し, 腹部大動脈人工血管置換術を行い, 移植腎を温存し得た1例を経験したので, 文献的考察を加え報告する. 「症例」症例は53歳の男性で, 44歳時に腎機能低下の精査で行われた腎生検により慢性糸球体腎炎と診断され, 慢性腎不全増悪により維持透析導入された. 47歳時に生体腎移植を行った. 血管吻合は移植腎動脈と右内腸骨動脈を端々吻合したが, 手術中に解離性大動脈瘤が疑われ, その後の精査でStanford B型と診断された. 術後移植腎の機能は良好であった. 厳密な血圧コントロールを行っていたが, 瘤径が拡大し, 手術目的に当院を紹介された. 「A. 入院時所見」入院時バイタルや心電図に異常を認めなかった. 血液検査では尿素窒素12.3mg/dl, クレアチニン0.97mg/dlであり, その他臓器障害を認めなかった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | abdominal aortic aneurysm, kidney transplant recipient, staged surgical repair, type B chronic aortic dissection |
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| English |
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| Title | Successful Abdominal Aortic Aneurysm Repair in Kidney Transplant Recipient―Staged Repair for Type B Chronic Aortic Dissection― |
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| Authors | Kentaro Umezu*, Satoshi Saito*, Tomohiro Nishinaka*, Hideki Ishida**, Kazunari Tanabe**, Hiromi Kurosawa* |
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| Authors(kana) | |
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| Organization | *Tokyo Women's Medical University, Department of Cardiovascular Surgery, **Tokyo Women's Medical University, Department of Urology |
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| Journal | Circulation Control |
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| Volume | 29 |
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| Number | 2 |
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| Page | 163-166 |
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| Year/Month | 2008/9 |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Abdominal aortic aneurysm repair in kidney transplant recipients is still a surgical challenge. We performed surgical repair in a 53-year-old man who had a type B chronic aortic dissection and had undergone kidney transplantation 6 years earlier because of chronic glomerulonephritis. Since he had both a thoracic descending aortic aneurysm and a huge abdominal aortic aneurysm, a staged repair was planned. At operation, after dissection around the transplanted kidney, the kidney was perfused with cold Ringer's solution and albumin. Aortic revascularization was accomplished with a Yshaped graft. After prolonged rehabilitation and antibiotic treatment, he was discharged and was awaiting second-stage repair of the thoracic descending aortic aneurysm. |
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| Practice | Basic medicine |
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| Keywords | abdominal aortic aneurysm, kidney transplant recipient, staged surgical repair, type B chronic aortic dissection |
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