[A case of ruptured thoracoabdominal aortic aneurysm with aortitis syndrome--operation with selective cold visceral arteries perfusion].

K Furukawa, H Ohteki, K Doi
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Abstract

We report a successful result of treatment for a ruptured thoracoabdominal aortic aneurysm with aortitis syndrome. A 43-year-old male suffered sudden low back pain, that was diagnosed as a ruptured thoracoabdominal aortic aneurysm based on abdominal computed tomography. Preoperative angiography revealed a thoracoabdominal aortic aneurysm with occlusion of the superior mesenteric artery, and well developed Riolan's archade. The aneurysm was replaced by a prosthetic graft with partial femoro-femoral bypass in conjunction with selective cold perfusion for the visceral arteries. Total extracorporeal circulation time, and aortic clamptime, was 187 minutes and 132 minutes, respectively. The postoperative courses of liver and renal function were excellent. The patient recovered from surgery uneventfully. It was suggested that selective cold visceral perfusion was effective for prevention of renal and liver dysfunction associated with a ruptured thoracoabdominal aneurysm.

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【胸腹主动脉瘤破裂合并大动脉炎综合征1例——选择性内脏动脉冷灌注手术】。
我们报告一个成功的结果治疗破裂胸腹主动脉瘤与大动脉炎综合征。一名43岁男性突发腰痛,经腹部计算机断层扫描诊断为胸腹主动脉瘤破裂。术前血管造影显示胸腹主动脉瘤伴肠系膜上动脉闭塞,Riolan拱廊发育良好。动脉瘤被假体移植物取代,部分股股分流,并选择性冷灌注内脏动脉。总体外循环时间和主动脉夹持时间分别为187分钟和132分钟。术后肝肾功能恢复良好。病人手术后恢复得很顺利。提示选择性内脏冷灌注可有效预防胸腹动脉瘤破裂所致肾、肝功能障碍。
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