Kamota T, Ikenaga S, Ikeda Y, Okada H
Department of Cardiovascular Surgery, Tokuyama Central Hospital, Shunan, Japan.
Kyobu Geka. 2011 Apr;64(4):344-7.
A 65-year-old man with left subclavian artery aneurysm, detected by enhanced computed tomography (CT), was referred to our hospital. The CT revealed intrathoracic left subclavian artery aneurysm (maximum diameter, 5 cm) at the takeoff of the aortic arch. Surgery was indicated considering the risks of rupture and embolism. The aneurysm was exposed through median sternotomy. Cardiopulmonary bypass was established with cannulation of the right axillary artery, left femoral artery, superior vena cava (SVC), and inferior vena cava (IVC). Circulatory arrest and isolated cerebral perfusion were achieved at a core temperature of 23 degrees C. Total arch replacement was performed using a 26 mm 4-branched Triplex graft, and the left subclavian artery was reconstructed by branch-left axillary artery bypass. The postoperative course was uneventful. He was discharged on the 22nd postoperative day.
一名65岁男性，经增强计算机断层扫描（CT）检查发现左锁骨下动脉瘤，遂转诊至我院。CT显示主动脉弓起始部的胸内左锁骨下动脉瘤（最大直径5cm）。考虑到破裂和栓塞风险，建议进行手术。通过正中胸骨切开术暴露动脉瘤。经右腋动脉、左股动脉、上腔静脉（SVC）和下腔静脉（IVC）插管建立体外循环。在核心温度23摄氏度时实现循环停止和选择性脑灌注。使用26mm四分支三联移植物进行全弓置换，并通过分支-左腋动脉旁路重建左锁骨下动脉。术后过程顺利。患者于术后第22天出院。
