A Case of Surgical Treatment for Type A Aortic Dissection in a Patient with Tracheostomy.
10.4326/jjcvs.32.31
- VernacularTitle:気管切開を有するＡ型大動脈解離に対する１手術例
- Author:
Harunobu Matsumoto
;
Koji Tsuchiya
;
Masato Nakajima
;
Hideki Sasaki
;
Narutoshi Hibino
;
Kimio Yamamoto
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2003;32(1):31-33
- CountryJapan
- Language:Japanese
-
Abstract:
The approach for the heart and proximal aorta in a patient with a tracheostomy poses difficult problems such as mediastinitis and inadequate operative exposure. We report a case of successful surgical treatment for type A aortic dissection in a patient with tracheostomy using a Y shaped skin incision and median full-sternotomy. A 63-year-old woman with a tracheostomy was referred to our hospital because of type A thrombosed aortic dissection and cardiac tamponade. At first we treated the patient conseservatively, but follow-up CT taken on the 20th day after onset revealed that false lumen of the ascending aorta was patent and the size of ascending aorta had increased to 6cm in diameter. We therefore performed hemiarch replacement (24mm Hemashield gold graft) through a Y shaped skin incision and median full-sternotomy. The postoperative course was uneventful and she was discharged on the 19th postoperative day.
