[症例報告]胸部下行大動脈異型縮窄(大動脈炎症候群)に対するInnomino-abdominal aortic bypassgraft.
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A female patient with hypertension ( 200 mmHg of systolic blood pressure ) and atypical coarctation of the thoraco-abdominal aorta due to aortitis syndrome, which successfully underwent innomino-abdominal synthetic bypass graft, is presented. At hospitalization of the patient, blood pressure was 188/90 mmHg in the left arm and 148/70 mmHg in the right arm with administration of 30 mg daily of nifedipine. A grade 2 systolic murmur was evident at the precordial, bilateral supraclavicular and upper abdominal regions with diminished pulses of bilateral femoral arteries. Aortography revealed irregular narrowing of the descending thoracic as well as abdominal aorta with remarkable stenosis of bilateral renal arteries at origins. The right subclavian artery was segmentally occluded. In the procedure of innomino-abdominal aortic bypass graft, a double velour knitted Dacron qraft, 14 mm in diameter, was anastomosed to the innominate artery in an end-to-side fashion and the graft was drawn to the epigastrium through a substernal tunnel and then to the abdomen through a right extraperitoneal route. The distal end of the graft was anastomosed to the infra-renal acdominal aorta in an end-to-side fashion. Postoperatively, the patency of the graft was clearly demonstrated by RI angiography with adequate pulses of bilateral pedal and posterior tibial arteries at the hospital discharge. The patient has now been well with approximately 150 mmHg of systolic blood pressure with administration of 30 mg daily of nifedipine 3 months after surgery. Innomino-abdominal aortic synthetic bypass graft is a safe and effective alternative procedure in surgical treatment for atypical coarctation of the aorta.
- 琉球大学医学部の論文
- 1984-00-00
琉球大学医学部 | 論文
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