Kuniyoshi Y, Koja K, Akasaki M, Miyagi K, Shimoji M, Kudaka M, Uezu T, Arakaki K, Sakuta H, Kamada Y
Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Surg Today. 1998;28(11):1206-9. doi: 10.1007/s005950050316.
We report herein the case of a patient in whom aneurysms of the bilateral deep femoral arteries (DFA) and multiple iliac aneurysms associated with severe aortic valve disease were successfully treated by a two-staged operation. The patient was a 74-year-old man who had dense calcification of the ascending aorta and aortic arch. Prior to aortic valve replacement (AVR), the aneurysms of the DFA and internal iliac arteries were resected. The terminal end of the abdominal aorta and bilateral common iliac arteries were then reconstructed with a Y graft to be used as a possible alternative arterial input route in place of the ascending aorta for extracorporeal circulation during the AVR. The inferior mesenteric artery (IMA) was well developed, and the external iliac arteries and their branches were preserved at aneurysmectomy. Postoperatively, there was no ischemia of the pelvic organs or the hip muscles. The AVR was subsequently performed 5 weeks after the first operation, and the patient was discharged after an uneventful postoperative course.
我们在此报告一例患者,其双侧股深动脉(DFA)动脉瘤和多发髂动脉瘤合并严重主动脉瓣疾病,通过两阶段手术成功治疗。该患者为74岁男性,升主动脉和主动脉弓有致密钙化。在进行主动脉瓣置换(AVR)之前,切除了DFA和髂内动脉的动脉瘤。然后用Y形移植物重建腹主动脉末端和双侧髂总动脉,作为在AVR期间体外循环时替代升主动脉的可能动脉输入途径。肠系膜下动脉(IMA)发育良好,在动脉瘤切除术中保留了髂外动脉及其分支。术后,盆腔器官或髋部肌肉无缺血情况。首次手术后5周随后进行了AVR,患者术后恢复顺利,出院。