Kan C B, Huang C H, Lai S T
Department of Surgery, Taipei Veterans General Hospital, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 2000 Oct;63(10):779-83.
A 40-year-male was admitted to our hospital after falling from a four-story height. Thoracic aortic rupture was suspected based on chest roentgenography and helical computed tomography. The patient was in the operating room within 6 hours after admission to the hospital. A median sternotomy with a left thoracotomy in the fifth intercostal space was done after left femoral arterial cannulation. Profound hypothermic circulation arrest with retrograde cerebral perfusion was applied. The site of aortic rupture was the descending aorta, just distal to the origin of the left subclavian artery. There were two areas of rupture within 2 cm of each other. The ruptured aorta was grafted with a 20-mm woven double-velour Hemashield graft. The total circulatory arrest time was 80 minutes and the cardiopulmonary bypass time was 290 minutes. The postoperative course was complicated by prolonged mechanical ventilation support due to pulmonary contusion. The patient was discharged 30 days after surgery without neurologic deficit.
一名40岁男性从四层楼高的地方坠落后来我院就诊。根据胸部X线和螺旋计算机断层扫描怀疑有胸主动脉破裂。患者入院后6小时内被送入手术室。在左股动脉插管后，行正中胸骨切开术并在第五肋间行左胸廓切开术。采用深度低温循环停搏并逆行脑灌注。主动脉破裂部位为降主动脉，恰好在左锁骨下动脉起始部的远端。在彼此相距2厘米的范围内有两个破裂区域。用一个20毫米编织双绒Hemashield移植物对破裂的主动脉进行移植。总循环停搏时间为80分钟，体外循环时间为290分钟。术后因肺挫伤需要长时间机械通气支持，病程复杂。患者术后30天出院，无神经功能缺损。
