| Surgical Strategy for Thoracic
Aortic Aneurysm with Abdominal Aortic Aneurysm |
(Department of Cardiovascular Surgery, The Heart
Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan)
| Hiroshi Furukawa |
Shigeyuki Aomi |
Yasutaka Ueno |
| Satoshi Noji |
Kazuhiko Uwabe |
Shinichiro Kihara |
| Hisao Kurihara |
Akihiko Kawai |
Hiroshi Nishida |
| Masahiro Endo |
Hitoshi Koyanagi |
|
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We evaluated the surgical strategy
for thoracic aortic aneurysm associated with abdominal aortic
aneurysm. From January 1982 to March 1999, 24 consecutive patients
underwent surgical treatment for thoracic aortic aneurysm with
abdominal aortic aneurysm. Staged operation was performed if
one was only slightly dilated, but extensive operation was needed
if the size of both aneurysms was greater than 6cm. In cases
of thoracic aortic aneurysm with abdominal aortic aneurysm up
to 4cm in size, surgical treatment was performed only for the
thoracic aortic aneurysm. Circulatory support during operation
was established from the ascending aorta, and circulatory arrest
with deep hypothermia and retrograde cerebral perfusion were
used for brain protection during surgery for thoracic aortic
arch aneurysm. Hospital mortality was 12.5% (3/24 cases). The
causes of death were cerebral infarction and respiratory failure.
Antegrade systemic perfusion and aortic no-touch technique were
an effective method of surgery for thoracic aortic aneurysm with
abdominal aortic aneurysm to avoid perioperative embolism and
major complications. We successfully performed staged operation,
but regular radiographic follow-up was needed.
Jpn. J. Cardiovasc. Surg. 30: 285-289 (2001) |
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