| Two-Staged Operation for Multiple Aortic Aneurysm |
| Etsuro Suenaga |
Hisao Suda |
Yuji Katayama |
| Manabu Sato |
Noriko Yamada |
Tsuyoshi Itoh* |
(Department of Cardiovascular Surgery, Nagasaki Kouseikai Hospital, Nagasaki, Japan and Department
of Thoracic and Cardiovascular Surgery, Saga Medical School*, Saga, Japan)
|
A 69-year-old man was admitted for treatment of thoracic aneurysm. DSA
revealed multiple aortic aneurysms: three true aneurysms which were located
at the distal arch, the thoracoabdominal aorta at the diaphragm level and
the infrarenal abdominal aorta, 60 mm, 55 mm and 55 mm in diameter, respectively
and two pseudo-aneurysms which were located in the abdominal aorta just
below the right renal artery and the right common iliac artery. We decided
to perform a two-staged operation. Before the first operation, 1,200 ml
of autologous blood was stored for perioperative blood transfusion. Initially,
total arch replacement was performed using deep hypothermic circulatory
arrest and antegrade selective cerebral perfusion. One month after the
first operation, total thoraco-abdominal aorta replacement was performed
by a retroperitoneal approach with mild hypothermia. The Th 9, 10 and 11
intercostal arteries were reconstructed. Distal anastomosis was performed
at both common iliac arteries. Blood transfusion was not reqired for blood
pooling and reduction of primig volume in the cardiopulmonary bypass system.
Jpn. J. Cardiovasc. Surg. 29: 396-399 (2000) |
|
