A Case of Ruptured Thoracic Aortic Aneurysm Requiring Two-Stage Sternal Closure due to Posterior Mediastinal Hematoma
10.4326/jjcvs.38.376
- VernacularTitle:後縦隔血腫により二期的胸骨閉鎖を必要とした胸部大動脈瘤破裂の1例
- Author:
Yukihiro Hayatsu
;
Koichi Nagaya
;
Kei Sakuma
;
Mitsuhide Kakihata
;
Susumu Nagamine
- Publication Type:Journal Article
- Keywords:
ruptured thoracic aortic aneurysm;
posterior mediastinum hematoma;
two-stage sternal closure
- From:Japanese Journal of Cardiovascular Surgery
2009;38(6):376-379
- CountryJapan
- Language:Japanese
-
Abstract:
A 70-year-old man with severe chest pain was transferred to our hospital by ambulance. Computed tomography revealed a ruptured thoracic aortic aneurysm and massive bleeding into the posterior mediastinum. Emergency total aortic arch replacement was performed through median sternotomy. However sternal closure induced severe hypotension because the heart was elevated anteriorly by the posterior mediastinal hematoma. The hematoma could not be eliminated fully so the sternum was kept open at the first operation followed by delayed sternal closure 3 days after the operation. After that, the postoperative course was uneventful and the patient was discharged on postoperative day 43.
