Tsukioka Katsuaki, Kono Tetsuya, Takahashi Kohei, Kehara Hiromu, Urashita Shuichi, Komatsu Kazunori
Department of Cardiovascular Surgery, Iida Municipal Hospital, Iida, Nagano, Japan.
Department of Cardiovascular Surgery, Suwa Red Cross Hospital, Suwa, Nagano, Japan.
Ann Vasc Dis. 2018 Mar 25;11(1):138-142. doi: 10.3400/avd.cr.17-00033.
A 75-year-old woman was involved in a traffic accident and suffered retrograde type A aortic dissection, multiple rib fractures, and grade II hepatic injury accompanied by intraperitoneal bleeding. We performed total arch replacement using an open stent graft with cardiopulmonary bypass and circulatory arrest. This procedure requires anticoagulation and hypothermia, which are principally contraindicated in severe trauma patients. However, this situation was resolved by managing the patient non-operatively for 7 days, confirming the stabilization of other injured organs, and then performing the surgery. She required prolonged postoperative rehabilitation; however, she recovered steadily.
一名75岁女性遭遇交通事故，患有逆行性A型主动脉夹层、多根肋骨骨折以及伴有腹腔内出血的II级肝损伤。我们使用带体外循环和循环停止的开放式支架移植物进行了全弓置换术。该手术需要抗凝和低温，而这在严重创伤患者中原则上是禁忌的。然而，通过对患者进行7天的非手术治疗，确认其他受伤器官稳定后再进行手术，这一情况得到了解决。她术后需要长期康复；不过，她恢复得很稳定。
