| Patch Graft Aortoplasty for Repair
of Chronic Aortic Dissection |
(Department of Cardiovascular Surgery, Kitaibaraki
City General Hospital, Kitaibaraki, Japan and Department of Surgery,
Institute of Clinical Medicine, University of Tsukuba*, Tsukuba,
Japan)
| Shinji Akishima |
Junichi Sakurai |
Tomoaki Jikuya* |
|
A 72-year-old woman was admitted
as an emergency case to our hospital because of chest oppression.
She had a history of admission due to the same symptoms about
9 months previously. Her chest computed tomography showed a dissection
of the ascending aorta (DeBakey type II). We suspected an acute
aortic dissection and an emergency operation with CPB was performed.
The ascending aorta was markedly enlarged, but the dissected
adventitia did not appear weakened. Moreover, there was no bloody
pericardial effusion which is specific to acute aortic dissection.
When the pseudo-lumen was exposed, a firm intimal flap and single
entry hole were recognized. The chronic phase of aortic dissection
was finally diagnosed. Then the dissected adventitia and intimal
flap were removed and a patch graft aortoplasty with a tailored
26mm gelatin-impregnated knitted Dacron vascular graft was employed
because the residual aortic wall was normal in size and consisting.
Her postoperative course was uneventful and there was no evidence
of recurrence of aortic dissection or enlargement 2 years after
the operation. We conclude that patch aortoplasty for repair
of chronic aortic dissection can be effective when the range
of dissection is restricted and te residual aortic wall is normal.
Jpn. J. Cardiovasc. Surg. 33: 178-181 (2004) |
|
