|
KMID : 0371319710130040023
|
|
Journal of the Korean Surgical Society
1971 Volume.13 No. 4 p.23 ~ p.32
|
|
|
Surgical Correction of the Descending Thoracic Aortic Aneurysms Using Letf Heart Bypass Technique
|
|
柳會性/Yoo, H.S.
洪承錄/문한배/徐相賢/李浩一/Hong, S.R./Moon, H.B./Suh, S.H./Lee, H.I.
|
|
|
Abstract
|
|
|
Surgical procedures on the thoracic aorta call for isolation of the aorta above and below the
operative field. In aortic aneurysm the collateral circulation is not sufficently developed, and so
the need then arises for a method of bypassing the operative field. A temporary graft sewn to the
aorta can solve this problem, but this requires elaborate arterial suturing. Far simpler is the in
stallation of a left heart bypass where blood is obtained from the left atrium through a plastic
cannula and pumped into the distal aorta through the femoral artery.
The authors recently experienced two cases of surgical correction of the descending thoracic aortic
aneurysm treated with excision of the aneurysum and replacement of woven Dacron graft under
moderate hypothermia plus left heart bypass technique in September, 1967, and May, 1968,
respectively.
Case Ⅰ was 27 year old woman who had fist sized fusiform aneurysm in the upper third of the
descending thoracic aorta onvolving the left subclavian artery. Histopathological diagnosis was
cystic medial necrosis in this case.
Case Ⅱ was 34 year old fisherman who had diffusely dilated atherosclerotic descending thoracic
aortic aneurysm extending from the point just distal to the left subclavian arterial origin down to
the level of the celiac artery.
During left heart bypass the pump flow was about 25㎖/㎏/min. in both cases, and circulation
occlusion time were 34 minutes in case I and 73 minutes in case Ⅱ. Although there were some
technical difficulties to maintain the systolic arterial blood pressure at the right arm aroung the
level of 10㎜Hg to 30㎜Hg above the preclamping pressure level during the cross clamping of
the aorta for regulating efficient perfusion flow rate, the operations were successful without
appreciable complications.
Immediate postoperative course had been uneventful except for aspiration pneumonitis in case Ⅱ.
The follow-up were possible up to date marking 2 years and 3 months in case Ⅰ, and 3 years in
case Ⅱ. Both patients has been doing well with ordinary activities except for some complaint of
right hypochondrial discomfort in case Ⅱ who had mild aneurysmal change in the abdominal aorta.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|