| A Case of Simultaneous Surgery
for Distal Aortic Arch Aneurysm Complicated by Left Ventricular
Aneurysm |
(Department of Cardiovascular Surgery, Kobe Rousai
Hospital, Kobe, Japan)
| Ikuro Kitano |
Noboru Wakita |
Masahiro Sakata |
| Hiroya Minami |
Yujiro Kawanishi |
|
|
A 72-year-old man consulted a local
physician due to an episode of loss of consciousness. When chest
CT was performed after amelioration of symptoms, aneurysmal dilation
was detected at the distal aortic arch. On CT, a distal aortic
arch aneurysm appeared to be a sacciform aneurysm measuring 55mm
in maximum diameter. In addition, coronary arteriography demonstrated
complete obstruction of left anterior descending branch ＃6, while
left ventriculography demonstrated left ventricular aneurysm
due to old myocardial infarction. The left ventricular end-diastolic
volume was increased to 285ml, and the end-systolic volume was
increased to 224ml. Moreover, the left ventricular ejection fraction
was markedly decreased to 21%. The distal aortic arch aneurysm
was treated by total aortic arch replacement. Considering the
postoperative development of cardiac failure, the left ventricular
aneurysm was simultaneously treated by endoventricular patch
plasty, the so-called Dor operation. The postoperative course
of this patient was satisfactory, because the end-diastolic volume
was decreased to 241ml, and the end-systolic volume was also
decreased to 147ml. Furthermore, the left ventricular ejection
fraction was increased to 39%, demonstrating an improvement in
left ventricular function. In Japan, there have not been any
reports describing simultaneous surgery for thoracic aortic aneurysm
complicated by left ventricular aneurysm. Therefore, the present
study reports the course of this patient, including the indications
of endoventricular patch plasty.
Jpn. J. Cardiovasc. Surg. 30: 99-102 (2001) |
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