右位主动脉弓远端主动脉弓动脉瘤的全弓置换术。

Total arch replacement for a distal aortic arch aneurysm with right aortic arch.

作者信息

Kiokawa Keiko, Goh Kazutomo, Akasaka Nobuyuki, Azuma Nobuyoshi, Inaba Masashi, Sasajima Tadahiro

机构信息

First Department Surgery and Emergent Medicine, Asahikawa Medical University, Asahikawa-city, Hokkaido, Japan.

出版信息

Ann Thorac Surg. 2007 Feb;83(2):e3-5. doi: 10.1016/j.athoracsur.2006.10.045.

DOI:10.1016/j.athoracsur.2006.10.045

PMID:17257948

Abstract

Right-sided aortic arch accompanied by an aberrant origin of the left subclavian artery is rare and seen in 0.05% approximately 0.1% of the population. A 73-year-old woman with this anomaly was admitted to our institution because of the enlargement of the distal aortic arch aneurysm. She also had mild dysphagia. The size of the aneurysm was 70 mm in diameter and she underwent total arch replacement using selective cerebral perfusion through a median sternotomy. Additional right thoracotomy was not required and four cervical vessels were reconstructed. The postoperative course was uneventful. This case report shows median sternotomy alone may provide sufficient access for this pathology.

摘要

右位主动脉弓伴左锁骨下动脉异常起源较为罕见，在人群中的发生率约为0.05%至0.1%。一名患有这种异常的73岁女性因远端主动脉弓动脉瘤增大而入住我院。她还伴有轻度吞咽困难。动脉瘤直径为70毫米，她通过正中胸骨切开术采用选择性脑灌注进行了全弓置换。无需额外进行右胸切开术，重建了四根颈部血管。术后过程顺利。本病例报告表明，仅正中胸骨切开术可能为这种病变提供足够的手术入路。