Successful Surgical Management of an Aortic Arch Aneurysm with an Aorto-Pulmonary Artery Fistula
	    		
	    			
	    			
		        		
			        		
		        		
			        
		   		
		   		
		   			
		   		
	    	
    	 
    	10.4326/jjcvs.32.137
   		
        
        	
        		- VernacularTitle:手術により救命しえた弓部大動脈りゅう‐肺動脈ろうの1治験例
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Kazuhiro Suzuki
			        		
			        		;
		        		
		        		
		        		
			        		Kimikazu Hamano
			        		
			        		;
		        		
		        		
		        		
			        		Sayaka Hanada
			        		
			        		;
		        		
		        		
		        		
			        		Masanori Hayashi
			        		
			        		;
		        		
		        		
		        		
			        		Bunngo Shirasawa
			        		
			        		;
		        		
		        		
		        		
			        		Hiroshi Itou
			        		
			        		;
		        		
		        		
		        		
			        		Akihito Mikamo
			        		
			        		;
		        		
		        		
		        		
			        		Masaki Miyamoto
			        		
			        		
		        		
		        		
		        		
		        		
		        		
			        		
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Journal Article
 
        	
        	
            
            
            	- From:Japanese Journal of Cardiovascular Surgery
	            		
	            		 2003;32(3):137-140
	            	
            	
 
            
            
            	- CountryJapan
 
            
            
            	- Language:Japanese
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	A 72-year-old woman had undergone resection and graft replacement of the proximal ascending aorta for a DeBakey type II aortic dissection. She presented again 7 years later with progressive dyspnea and a cough. Computed tomography confirmed an aortic arch aneurysm and Doppler echocardiography demonstrated aortopulmonary shunting. Cardiac catheterization revealed a fistula between the aorta and pulmonary artery with a 54.3% left-to-right shunt and a Qp/Qs of 2.19. Operative repair was performed under profound hypothermic circulatory arrest with selective cerebral perfusion. The aortopulmonary artery fistula was closed from within the aneurysm using an equine pericardial patch and the transverse aortic arch was resected and replaced with a graft. The patient recovered uneventfully and was discharged on postoperative day 43.