6 胸腹部大動脈再建(シンポジウム成人心臓血管治療の最前線 : Interventionと外科治療)(第571回新潟医学会)

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Repair of thoracoabdominal aortic aneurysm (TAAA) still has a significant risk for postoperative mortality and adverse outcome such as paraplegia. Therefore TAAA repair is a very challenging operation for vascular surgeons. The mortality rate varies depending on the type of TAAA. Spiral incision with left thoracotomy, division of the diaphragm and retroperitoneal approach is used for repair of TAAA. Distal perfusion and sequential cross-clamping of the aorta are basic adjuncts for prevention of spinal cord injury. Deep hypothermia and circulatory arrest are sometimes used, especially in cases of involvement of the proximal descending thoracic aorta and / or distal aortic arch. Reconstruction of intercostal arteries and visceral arteries depends on the extent of the aneurysm. From January 1998 to June 2001, 11 patients with TAAAs underwent operations in our department. The mean age of the patients was 63 years, and the male / female ratio was 8 / 3. Distribution of TAAA was following: group I, 3; group II, 1; group III, 6; group IV, 1. Two patients suffered from chronic dissection. Four patients underwent emergency surgery because of ruptured aneurysms. Sequential cross-clamping of the aorta was used in all patients under partial cardiopulmonary bypass. Intercostal arteries were reconstructed in 7 patients. In-hospital mortality rate was 18 % (2 patients). There were no spinal cord injuries. Nine patients, including 3 who underwent emergency repair, were discharged from the hospital without any sequelae.
新潟大学の論文
2003-02-10

6 胸腹部大動脈再建(シンポジウム成人心臓血管治療の最前線 : Interventionと外科治療)(第571回新潟医学会)

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