Furukawa K, Ohteki H, Doi K
Department of Cardiovascular Surgery, Saga Prefectural Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Oct;45(10):1747-50.
We report a successful result of treatment for a ruptured thoracoabdominal aortic aneurysm with aortitis syndrome. A 43-year-old male suffered sudden low back pain, that was diagnosed as a ruptured thoracoabdominal aortic aneurysm based on abdominal computed tomography. Preoperative angiography revealed a thoracoabdominal aortic aneurysm with occlusion of the superior mesenteric artery, and well developed Riolan's archade. The aneurysm was replaced by a prosthetic graft with partial femoro-femoral bypass in conjunction with selective cold perfusion for the visceral arteries. Total extracorporeal circulation time, and aortic clamptime, was 187 minutes and 132 minutes, respectively. The postoperative courses of liver and renal function were excellent. The patient recovered from surgery uneventfully. It was suggested that selective cold visceral perfusion was effective for prevention of renal and liver dysfunction associated with a ruptured thoracoabdominal aneurysm.
我们报告了1例采用主动脉炎综合征治疗胸主动脉瘤破裂的成功病例。一名43岁男性突发腰痛,经腹部计算机断层扫描诊断为胸主动脉瘤破裂。术前血管造影显示胸主动脉瘤合并肠系膜上动脉闭塞,且Riolan弓发育良好。通过人工血管置换动脉瘤,并进行部分股-股旁路移植术,同时对内脏动脉进行选择性冷灌注。体外循环总时间和主动脉阻断时间分别为187分钟和132分钟。术后肝肾功能恢复良好。患者术后恢复顺利。提示选择性冷内脏灌注对预防胸主动脉瘤破裂相关的肝肾功障碍有效。