[The use of a circulatory assistance device during replacement of descending aorta to treat chronic aortic dissection; report of a case].
A 70-year-old woman with Marfan syndrome had undergone Y-graft replacement for abdominal aortic aneurysm at the age of 61. She recently underwent axillo-bifemoral bypass to treat ischemia of the lower extremities caused by acute aortic dissection. The patient was admitted for surgical treatment to treat a remaining dissecting descending aortic aneurysm. Aortography revealed that the entry was present at the takeoff of the left subclavian artery, and that the false lumen extended up the proximal anastomosis of the Y-graft to where the true lumen ended. All the abdominal vessels originated from this false lumen, with the lower extremities being supplied via an axillo-bifemoral bypass. No re-entry was detected. Replacement of the descending aorta was carried out using a 28 mm woven Dacron graft. First, double-barreled distal anastomosis under single clamping was performed; then, proximal anastomosis was carried out under antegrade perfusion from the graft to shorten the ischemic time of the abdominal organs. The patient suffered no postoperative complications.
Fumoto
H
H
Department of Cardiovascular Surgery, Nagasaki Kôseikai Hospital, Nagasaki, Japan.
Suda
H
H
Nakayama
Y
Y
Katayama
Y
Y
D000368:Aged; D000784:Aortic Dissection / Q000209:etiology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000209:etiology / Q000601:surgery*; D001243:Assisted Circulation / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008382:Marfan Syndrome / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome