Total aortic replacement in a patient with mega aorta syndrome--a case report.
Total aortic replacement in a patient with mega aorta syndrome--a case report.
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巨主动脉综合征患者的全主动脉置换术——病例报告。
DOI：
10.1253/jcj.59.354
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
K. Oishi
中科院分区：
文献类型：
--
作者：
S. Aoyagi;H. Akashi;Y. Higa;S. Hiromatsu;K. Yamana;A. Oryoji;K. Kosuga;K. Oishi
一名64岁的妇女没有表现的马凡氏综合征被称为密切调查的脉动性腹部肿块。计算机断层扫描和磁共振图像显示整个主动脉（包括升主动脉并延伸至主动脉分叉处）呈囊状扩张，胸腹主动脉和腹主动脉迂曲。数字减影血管造影也显示整个主动脉扩张和轻微的主动脉瓣返流。然而，超声心动图或血管造影未发现主动脉瓣环扩张。整个主动脉在两个阶段被替换。首先，升主动脉（窦段除外）和主动脉弓的移植物置换在低温心肺转流和选择性脑灌注下使用象鼻技术进行。12周后，剩余的主动脉，包括降主动脉，右侧延伸至髂总动脉，左侧延伸至股总动脉，用股动脉和静脉插管的部分心肺转流术置换。我们认为大主动脉综合征患者最好采用全主动脉置换术治疗。本例的结果表明，象鼻技术适用于分期广泛主动脉置换术，并大大方便了第二期手术。
A 64-year-old woman without manifestations of Marfan syndrome was referred for the close investigation of a pulsatile abdominal mass. Computed tomographic scans and magnetic resonance images revealed aneurysmal dilatation of the entire aorta, including the ascending aorta and extending to the bifurcation of the aorta, as well as tortuousness of the thoracoabdominal and abdominal aorta. Digital subtraction angiography also showed aneurysmal dilatation of the entire aorta and trivial aortic regurgitation. However, aortic annular dilatation was not found by echocardiography or aortography. The entire aorta was replaced in two stages. First, graft replacement of the ascending aorta, except for the sinus segment, and the aortic arch was performed using an elephant trunk technique under hypothermic cardiopulmonary bypass with selective cerebral perfusion. Twelve weeks later, the remaining aorta, including the descending aorta and extending to the common iliac artery on the right side, and to the common femoral artery on the left side, was replaced with a partial cardiopulmonary bypass using femoral artery and vein cannulation. We believe that patients with mega aorta syndrome are best treated by total aortic replacement. The results in the present case indicate that the elephant trunk technique is useful for extensive aortic replacement in stages, and greatly facilitates the second stage operative procedures.