Hori Mariko, Yoshizaki Takamichi, Tamura Atsushi
Department of Cardiovascular Surgery, Itabashi Central General Hospital, Tokyo, Japan.
Kyobu Geka. 2024 Feb;77(2):136-139.
A 67-year-old male was admitted to our hospital for sudden onset chest pain and hoarseness. He underwent 2-debranching thoracic endovascular aortic repair for a ruptured aortic arch aneurysm four years prior. However, computed tomography (CT) revealed an aneurysmal rerupture due to a typeⅠa endoleak. We performed partial arch replacement with uncovered stent removal under intermittent hypothermic circulatory arrest. We needed to be more careful than usual open heart surgery because a non-anatomical bypass procedure was performed. The surgery was successful without any major complications, and the patient was discharged on the 23th postoperative day. Reinterventions post-endovascular repair are sometimes difficult;thus, open surgery could be useful for arch replacement.
一名67岁男性因突发胸痛和声音嘶哑入住我院。他四年前因主动脉弓动脉瘤破裂接受了去分支胸主动脉腔内修复术。然而，计算机断层扫描（CT）显示由于Ⅰa型内漏导致动脉瘤再次破裂。我们在间歇性低温循环停止下进行了部分主动脉弓置换并取出未覆盖的支架。由于进行了非解剖旁路手术，我们需要比常规心脏手术更加小心。手术成功，无任何重大并发症，患者于术后第23天出院。血管腔内修复术后的再次干预有时很困难；因此，开放手术对于主动脉弓置换可能是有用的。
