Ookawa Y, Kazui T, Yamamoto N, Ito T, Yamada O, Komatsu S
Department of Surery (Section 2), Sapporo Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Nov;38(11):2281-5.
It is not always easy to determine the causes of preoperative respiratory failure when either cardiac failure due to annuloaortic ectasia (AAE) or compression of the bronchus by aortic arch aneurysm are involved. A 64-year-old man was admitted to the emergency room of our hospital because of dyspnea and disturbance of consciousness. The findings of chest X-ray, UCG and CT scan on admission revealed AAE and aortic arch aneurysm, so we performed an emergency operation using Bentall's procedure. In spite of improvement of the cardiac failure after operation, hypercapnemia still remained, which was considered to be due to compression of the bronchus by the aortic arch aneurysm. Therefore, at the second stage, resection and replacement of the aortic arch aneurysm was performed with the aid of selective cerebral perfusion. After this operation, he could be weaned from the respirator.
当涉及到主动脉环扩张（AAE）导致的心力衰竭或主动脉弓动脉瘤压迫支气管时，术前呼吸衰竭的病因并不总是容易确定。一名64岁男性因呼吸困难和意识障碍入住我院急诊室。入院时胸部X线、超声心动图（UCG）和CT扫描结果显示为AAE和主动脉弓动脉瘤，因此我们采用Bentall手术进行了急诊手术。尽管术后心力衰竭有所改善，但高碳酸血症仍然存在，这被认为是由于主动脉弓动脉瘤压迫支气管所致。因此，在第二阶段，借助选择性脑灌注进行了主动脉弓动脉瘤的切除和置换。这次手术后，他能够脱离呼吸机。
