Nakamura Noriyuki, Adachi Koichi, Shinshi Mio, Imamura Yusuke, Tajima Yasushi, Nakata Hiroko
Department of Cardiovascular Surgery, Yokosuka Municipal Uwamachi Hospital, Yokosuka, Japan.
Kyobu Geka. 2021 Feb;74(2):147-151.
An 87-year-old male was referred to our hospital for surgery of saccular aortic arch aneurysm. As he had a history of thoracoplasty on his left side due to pulmonary tuberculosis, his aortic arch adhered to the apex of the left thorax. Total arch replacement(TAR) via median sternotomy was considered difficult, and anterolateral thoracotomy with partial sternotomy (ALPS) was performed. During surgery, we considered TAR difficult even with ALPS approach. Taking account of his age, aneurysmectomy and patch repair were chosen instead of TAR to shorten operation time. Although he suffered from diffuse cerebral infarction, he was discharged without neurological deficit at 39 days after operation.
一名87岁男性因囊状主动脉弓瘤被转诊至我院接受手术。由于他曾因肺结核接受过左侧胸廓成形术，其主动脉弓与左胸尖部粘连。经正中胸骨切开术进行全弓置换术（TAR）被认为困难，遂行前外侧开胸术联合部分胸骨切开术（ALPS）。手术过程中，即使采用ALPS入路，我们仍认为TAR困难。考虑到他的年龄，选择了动脉瘤切除术和补片修补术而非TAR，以缩短手术时间。尽管他患有弥漫性脑梗死，但术后39天出院时无神经功能缺损。
