| A Case of Surgical Treatment
for Type A Aortic Dissection in a Patient with Tracheostomy |
(Department of Cardiovascular Surgery and Department
of Internal Medicine*, Yamanashi Prefectural Central Hospital,
Yamanashi, Japan)
| Harunobu Matsumoto |
Koji Tsuchiya |
Masato Nakajima |
| Hideki Sasaki |
Narutoshi Hibino |
Kimio Yamamoto* |
|
The approach for the heart and proximal
aorta in a patient with a tracheostomy poses difficult problems
such as mediastinitis and inadequate operative exposure. We report
a case of successful surgical treatment for type A aortic dissection
in a patient with tracheostomy using a Y shaped skin incision
and median full-sternotomy. A 63-year-old woman with a tracheostomy
was referred to our hospital because of type A thrombosed aortic
dissection and cardiac tamponade. At first we treated the patient
conseservatively, but follow-up CT taken on the 20th day after
onset revealed that false lumen of the ascending aorta was patent
and the size of ascending aorta had increased to 6cm in diameter.
We therefore performed hemiarch replacement (24mm Hemashield
gold graft) through a Y shaped skin incision and median full-sternotomy.
The postoperative course was uneventful and she was discharged
on the 19th postoperative day.
Jpn. J. Cardiovasc. Surg. 32：31-33 (2003) |
|
