Ninomiya Hironori, Kuwabara Masachika, Hayase Takahiro, Furukawa Kouji, Onitsuka Toshio
Department of Cardiovascular Surgery, Miyazaki Prefectural Nobeoka Hospital, Kiyotake, Miyazaki 889-1692, Japan.
Jpn J Thorac Cardiovasc Surg. 2004 Mar;52(3):155-7. doi: 10.1007/s11748-004-0134-8.
A 73-year-old woman with a history of hypertension and hyperlipidemia presented with a sharp pain ranging from the right shoulder to the upper limb. She had suffered a sharp pain at rest accompanied by general fatigue and nausea for about ten months prior to admission. Her white blood cell count was 12,800/microl, and her serum C-reactive protein was 17.5 mg/dl. A chest computed tomography scan revealed an aneurysmal change of the origin of the brachiocephalic artery. Pseudoaneurysm due to infection and aortic dissection was considered as a preoperative diagnosis. A total arch replacement was performed under cardiopulmonary bypass, deep hypothermia, and selective cerebral perfusion. Postoperatively, a bacteriologic culture of the contents of the aneurysm revealed Staphylococcus aureus. Perioperative administration of antibiotics was effective and the postoperative course was uneventful.
一名73岁女性，有高血压和高脂血症病史，出现从右肩到上肢的剧痛。入院前约十个月，她在休息时出现剧痛，伴有全身乏力和恶心。她的白细胞计数为12,800/微升，血清C反应蛋白为17.5毫克/分升。胸部计算机断层扫描显示头臂动脉起始部有动脉瘤样改变。术前诊断考虑为感染性假性动脉瘤和主动脉夹层。在体外循环、深度低温和选择性脑灌注下进行了全弓置换。术后，动脉瘤内容物的细菌培养显示为金黄色葡萄球菌。围手术期使用抗生素有效，术后病程顺利。
