A Case of Ruptured Dissecting Aortic Aneurysm Involving a Right-sided Aortic Arch.
10.4326/jjcvs.25.275
- VernacularTitle:右大動脈弓に合併したＤｅＢａｋｅｙ ＩＩＩａ型解離性大動脈りゅう破裂の１治験例
- Author:
Toru Uezu
;
Kageharu Koja
;
Yukio Kuniyoshi
;
Kiyoshi Iha
;
Mitsuru Akasaki
;
Kazufumi Miyagi
;
Mitsuyoshi Shimoji
;
Manabu Kudaka
;
Akira Kusaba
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1996;25(4):275-278
- CountryJapan
- Language:Japanese
-
Abstract:
A case of ruptured dissecting aortic aneurysm (DeBakey IIIa) involving a right-sided aortic arch is reported. A 54-year-old man was admitted to our hospital with a complaint of severe back pain. Roentgenogram and enhanced computed tomography of the chest revealed a right-sided aortic arch, right descending thoracic aorta and right pleural effusion. Thoracocentesis of the right thoracic cavity revealed bloody fluid. The ruptured dissecting aortic aneurysm was suspected. The enhanced CT of the chest revealed leakage of the contrast medium at the level of the bifurcation of the trachea so aortography wasn't performed. There was a 2cm intimal tear in the descending aorta. Resection and grafting of the aneurysm via right thoracotomy was performed. The patient made an uneventful recovery and was discharged 4 weeks later. It is pointed out that the operative method and/or decision of the method of approach for the aneurysm involving a right arch are difficult because of the aberrant left subclavian artery and/or tortuous descending thoracic aorta. Impeccable judgement is needed for emergency operation of ruptured dissecting aneurysms like the present case.
