Endovascular Repair of Chronic Aortic Dissection Expansion from Distal Fenestration in Previous Graft Replacement
10.4326/jjcvs.37.345
- VernacularTitle:開窓術を併用した解離性大動脈瘤人工血管置換末梢側吻合部の瘤拡大に対しステントグラフト治療が奏功した1例
- Author:
Toshiro Ito
;
Yoshihiko Kurimoto
;
Nobuyoshi Kawaharada
;
Tomohiro Nakajima
;
Masaki Tabuchi
;
Mayuko Uehara
;
Yousuke Yanase
;
Akihiko Yamauchi
;
Toshio Baba
;
Tetsuya Higami
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2008;37(6):345-348
- CountryJapan
- Language:Japanese
-
Abstract:
A 58-year-old man was admitted because of enlargement in diameter of the descending thoracic aorta. Six years previously, he had undergone graft replacement of the proximal descending aorta due to a chronic dissecting aneurysm. During that surgery, distal fenestration involving resection of the intimal flap of the distal anastomotic site and graft replacement with distal anastomosis of the true and false lumen were performed. Our preoperative enhanced computed tomography (eCT) revealed a thoracic aortic aneurysm 58mm in diameter at the site of distal fenestration. Graft replacement through left lateral thoracotomy was considered difficult because of previous occurrence of methicillin-resistant Staphylococcus aureus (MRSA) empyema after the previous operation: hence, endovascular repair was done using a handmade stent graft to interrupt blood flow into the false lumen. The postoperative course was uneventful. Postoperative eCT showed the thrombosed false lumen and the shrinkage of the aneurysm from 58 to 38mm in diameter over a period of 18 months.
