Takigami K, Shiiya N, Sasaki S, Murashita T, Matsui Y, Yasuda K
Department of Cardiovascular Surgery, Hokkaido University, Sapporo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Apr;45(4):577-81.
Abdominal aortic aneurysms can now be successfully repaired with low mortality and few early complications. On the other hand, the cases that required operations for recurrent aneurysms have been increased during long term follow-up period. In such cases, there are many difficulties for operative procedures compared to their first operations and many risk factors. A case of successful operation for the thoracoabdominal aortic aneurysm associated with severe stenotic lesions of the visceral arteries and descending thoracic aneurysm and left common iliac artery aneurysm are reported. A 74-year-old man who underwent operation for infrarenal abdominal aortic aneurysm and left nephrectomy 7 years and 9 months ago at our institution developed an aneurysm just above the proximal anastomosis with severe stenotic lesions of the visceral arteries. At the same time, descending thoracic aortic aneurysm and left common iliac artery aneurysm were associated. And he had ischemic heart disease. Under selective perfusion of the visceral arteries, graft replacement of these aneurysms and reconstruction of superior mesenteric artery and right renal artery were done. The patient had good post operative course and started oral feeding at 3 post operation day. He returned to his occupation and is doing well with no trouble one and half year after operation.
腹主动脉瘤现在可以通过低死亡率和很少的早期并发症成功修复。另一方面，在长期随访期间，需要对复发性动脉瘤进行手术的病例有所增加。在这种情况下，与首次手术相比，手术操作存在许多困难和许多危险因素。本文报告一例成功手术治疗胸腹主动脉瘤的病例，该病例合并内脏动脉严重狭窄病变、降主动脉瘤和左髂总动脉瘤。一名74岁男性，7年9个月前在我院接受了肾下腹主动脉瘤手术和左肾切除术，在近端吻合口上方出现了一个动脉瘤，并伴有内脏动脉严重狭窄病变。同时，合并降主动脉瘤和左髂总动脉瘤。并且他患有缺血性心脏病。在内脏动脉选择性灌注下，对这些动脉瘤进行了人工血管置换，并重建了肠系膜上动脉和右肾动脉。患者术后恢复良好，术后第3天开始经口进食。他恢复了工作，术后一年半情况良好，没有问题。
