Sato M, Fukuda I, Osaka M
Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Ibaraki, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Oct;45(10):1774-7.
A 57-year-old woman in whom an abnormality was detected on the chest X-ray presented with no signs or symptoms other than hypertension. Several examinations revealed that she had aortic coarctation of the isthmus with two aneurysm in the arch. One aneurysm was located in the root of the left subclavian artery, another was just distal of the first aneurysm. For prevention of rupture of the aneurysms and treatment of hypertension, aortic arch reconstruction was performed with the aid of selective cerebral perfusion. The postoperative course was uneventful and she was discharged 19 days after the operation with normalization of her blood pressure. At the operation in this case, the combination of the two approaches, median sternotomy and left 4th thoracotomy, was useful.
一名57岁女性因胸部X线检查发现异常而就诊,除高血压外无其他体征或症状。多项检查显示,她患有峡部主动脉缩窄,主动脉弓有两个动脉瘤。一个动脉瘤位于左锁骨下动脉根部,另一个在第一个动脉瘤的远端。为预防动脉瘤破裂和治疗高血压,在选择性脑灌注辅助下进行了主动脉弓重建。术后过程顺利,术后19天血压恢复正常后出院。在该病例的手术中,正中胸骨切开术和左胸第四肋间切开术这两种方法的联合使用很有效。