Nakashima S, Kikuchi Y, Sakurada T, Hachiro Y, Kagaya H
Department of Cardiovascular Surgery, National Obihiro Hospital, Hokkaido, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 May;45(5):778-82.
The patient was 69-year-old male who admitted to our hospital in November 1995 with the complaint of abnormal shadow on chest C-ray. CT scan and aortogram revealed aneurysms of the distal aortic arch and innominate artery. Seventy-five percent stenosis of the right coronary artery was also found in coronary angiogram. The total arch replacement and reconstruction of the innominate artery and CABG to right coronary artery were performed with the aid of cold blood cardioplegia and selective cerebral perfusion and open distal anastomosis. Ascending aorta was used for arterial cannulation to avoid the thromboembolism due to retrograde perfusion from the femoral artery. Satisfactory postoperative course was obtained except transient left hemiplegia and post operative three-dimensional CT scan demonstrated the successful reconstruction. The patient was doing well 8 months postoperatively.
该患者为69岁男性，于1995年11月因胸部X光片出现异常阴影而入住我院。CT扫描和主动脉造影显示主动脉弓远端和无名动脉存在动脉瘤。冠状动脉造影还发现右冠状动脉有75%的狭窄。在冷血心脏停搏、选择性脑灌注和开放远端吻合术的辅助下，进行了全弓置换、无名动脉重建以及右冠状动脉冠状动脉旁路移植术。使用升主动脉进行动脉插管，以避免因股动脉逆行灌注导致的血栓栓塞。除了短暂的左偏瘫外，术后过程顺利，术后三维CT扫描显示重建成功。患者术后8个月情况良好。
