초록접수 현황
| 15F-009 | 포스터 발표 |
Thoracoabdominal Aortic Aneurysm Repair in a Patient with Aberrant Right Subclavian Artery and Chronic Aortic Dissection
송경섭, 김재범, 김재현, 박남희
계명대학교 의과대학 동산의료원 흉부외과학교실
Background : Aberrant right subclavian artery(ARSA) is a rare congenital vascular abnormality. It is often found with aortic dissection or aneurysm, and treatment of aortic aneurysm with ARSA is difficult.
Methods : A 46-year-old man with hypertension and ARSA was admitted to our hospital for chest pain on 2014. He undergone ascending aorta replacement for debakey type I aortic dissection on 2007 and descending aorta wrapping operation on 2009 for descending aortic aneurysm. CT on admission revealed extent II thoracoabdominal aortic aneurysm(TAAA) and the maximal diameter of aneurysm was 53mm.
Firstly, right common carotid-right subclavian artery bypass and ARSA proximal ligation were performed.
2 days after from operation, we performed extent II TAAA open repair via left thoracotomy. There was severe adhesion on aortic wrapping site. We performed proximal anastomosis on hypothermic circulatory arrest state after femoral artery and vein cannulation.
Results : Circulatory arrest time and total pump time was 47minutes and 253 minutes' respectively. He was discharged at post operative day 19 after manage of left inguinal lymphosele on femoral cannulation site.
At 1-year follow up, the patients is in good condition without a problem.
Conclusion : Although combined ARSA, extent II TAAA and redo-thoracotomy state with severe adhesion made operation more complex, we performed TAAA open repair successfully by two staged operation.
Methods : A 46-year-old man with hypertension and ARSA was admitted to our hospital for chest pain on 2014. He undergone ascending aorta replacement for debakey type I aortic dissection on 2007 and descending aorta wrapping operation on 2009 for descending aortic aneurysm. CT on admission revealed extent II thoracoabdominal aortic aneurysm(TAAA) and the maximal diameter of aneurysm was 53mm.
Firstly, right common carotid-right subclavian artery bypass and ARSA proximal ligation were performed.
2 days after from operation, we performed extent II TAAA open repair via left thoracotomy. There was severe adhesion on aortic wrapping site. We performed proximal anastomosis on hypothermic circulatory arrest state after femoral artery and vein cannulation.
Results : Circulatory arrest time and total pump time was 47minutes and 253 minutes' respectively. He was discharged at post operative day 19 after manage of left inguinal lymphosele on femoral cannulation site.
At 1-year follow up, the patients is in good condition without a problem.
Conclusion : Although combined ARSA, extent II TAAA and redo-thoracotomy state with severe adhesion made operation more complex, we performed TAAA open repair successfully by two staged operation.
책임저자: 김재현
계명대학교 의과대학 동산의료원 흉부외과학교실
연락처 : 송경섭, Tel: 053-250-7307 , E-mail : chest.songks@gmail.com
