Terada Y, Sakakibara K, Ohkawa S, Hattori T, Asakura T, Yoshimura T, Yamabuki K, Atsumi N, Zikuya T, Mitsui T
Institute of Clinical Medicine, University of Tsukuba, Japan.
Kyobu Geka. 1994 Jun;47(6):455-8.
A 69-year-old man underwent Cabrol's procedure for annuloaortic ectasia and complicated multiple cerebral infarction. Preoperative CT scan showed atherosclerotic changes from the aortic arch to descending aorta. During extracorporeal circulation, arterial cannulation was made through left subclavian artery to prevent cerebral infarction due to detouched atheroma from the descending aorta. Intraoperatively, the ascending aorta was also atheromatous and ulcerative. In this case, cerebral infarction was most likely due to detouched atheroma from the aortic arch in retrograde blood flow during extracorporeal circulation. To prevent this complication, selective cerebral perfusion during extracorporeal circulation should have been selected.
一名69岁男性因主动脉瓣环扩张症和复杂性多发性脑梗死接受了卡布罗尔手术。术前CT扫描显示从主动脉弓到降主动脉有动脉粥样硬化改变。在体外循环期间，通过左锁骨下动脉进行动脉插管，以防止降主动脉粥样斑块脱落导致脑梗死。术中发现升主动脉也有动脉粥样硬化和溃疡。在这种情况下，脑梗死很可能是由于体外循环期间逆行血流中主动脉弓粥样斑块脱落所致。为预防这一并发症，体外循环期间应选择选择性脑灌注。
