胸腹部大動脈置換術後に生じた visceral aortic patch aneurysm に対し2期的に hybrid aortic repair を施行した1例
症例は48歳男性．解離性大動脈瘤（DeBakey III B型）に対し25歳時に下行大動脈置換術，27歳時に上行大動脈瘤に対し上行大動脈＋部分弓部大動脈置換術，28歳時に残存解離による胸腹部大動脈瘤に対し胸腹部大動脈置換術を施行され外来で経過観察されていた．3回目の手術時に腹腔動脈・上腸間膜動脈・右腎動脈がVisceral aortic patch（VAP）を用いて再建されており，同部の残存している自家大動脈壁に瘤化（最大径70 mm×61 mm）を認めたため手術の方針となった．2回の左開胸手術後であったため2期的にhybrid aortic repairを施行する方針とし1回目にreno-v...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 49; no. 6; pp. 385 - 389 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本心臓血管外科学会
15.11.2020
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.49.385 |
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| Abstract | 症例は48歳男性．解離性大動脈瘤（DeBakey III B型）に対し25歳時に下行大動脈置換術，27歳時に上行大動脈瘤に対し上行大動脈＋部分弓部大動脈置換術，28歳時に残存解離による胸腹部大動脈瘤に対し胸腹部大動脈置換術を施行され外来で経過観察されていた．3回目の手術時に腹腔動脈・上腸間膜動脈・右腎動脈がVisceral aortic patch（VAP）を用いて再建されており，同部の残存している自家大動脈壁に瘤化（最大径70 mm×61 mm）を認めたため手術の方針となった．2回の左開胸手術後であったため2期的にhybrid aortic repairを施行する方針とし1回目にreno-visceral debranching手術，2回目にステントグラフト内挿術を行い，瘤の空置に成功した． |
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| AbstractList | 症例は48歳男性．解離性大動脈瘤（DeBakey III B型）に対し25歳時に下行大動脈置換術，27歳時に上行大動脈瘤に対し上行大動脈＋部分弓部大動脈置換術，28歳時に残存解離による胸腹部大動脈瘤に対し胸腹部大動脈置換術を施行され外来で経過観察されていた．3回目の手術時に腹腔動脈・上腸間膜動脈・右腎動脈がVisceral aortic patch（VAP）を用いて再建されており，同部の残存している自家大動脈壁に瘤化（最大径70 mm×61 mm）を認めたため手術の方針となった．2回の左開胸手術後であったため2期的にhybrid aortic repairを施行する方針とし1回目にreno-visceral debranching手術，2回目にステントグラフト内挿術を行い，瘤の空置に成功した． |
| Author | 山田, 隆熙 黄野, 皓木 柴田, 裕輔 焼田, 康紀 松宮, 護郎 上田, 秀樹 渡邊, 倫子 乾, 友彦 山本, 浩亮 松浦, 馨 |
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| References | 4) Bertoglio L, Mascia D, Cambiaghi T et al. Management of visceral aortic patch aneurysms after thoracoabdominal repair with open, hybrid, or endovascular approach. J Vasc Surg 2018 ; 67 : 1360-71. 9) Chiesa R, Melissano G, Civilini E et al. Two-stage combined endovascular and surgical approach for recurrent thoracoabdominal aortic aneurysm. J Endovasc Ther 2004 ; 11 : 330-3. 12) Tshomba Y, Melissano G, Logaldo D et al. Clinical outcomes of hybrid repair for thoracoabdominal aortic aneurysms. Ann Cardiothorac Surg 2012 ; 1 : 293-303. 3) Dardik A, Perler BA, Roseborough GS et al. Aneurysmal expansion of the visceral patch after thoracoabdominal aortic replacement : an argument for limiting patch size?. J Vasc Surg 2001 ; 34 : 405-10. 17) Chiesa R, Tshomba Y, Melissano G et al. Hybrid approach to thoracoabdominal aortic aneurysms in patients with prior aortic surgery. J Vasc Surg 2007 ; 45 : 1128-35. 6) Afifi RO, Sandhu HK, Trott AE et al. Redo thoracoabdominal aortic aneurysm repair : a single-center experience over 25 years. Ann Thorac Surg 2017 ; 103 : 1421-8. 2) Cruz K, LeMaire S, Weldon S et al. Thoracoabdominal aortic aneurysm repair with a branched graft. Ann Cardiothorac Surg 2012 ; 1 : 381-93. 7) Etz CD, Zoli S, Kari FA et al. Redo lateral thoracotomy for reoperative descending and thoracoabdominal aortic repair : a consecutive series of 60 patients. Ann Thorac Surg 2009 ; 88 : 758-67. 10) Black SA, Wolfe JH, Clark M et al. Complex thoracoabdominal aortic aneurysms : endovascular exclusion with visceral revascularization. J Vasc Surg 2006 ; 43 : 1081-9. 1) Crawford ES, Snyder DM, Cho GC et al. Progress in treatment of thoracoabdominal and abdominal aortic aneurysms involving celiac, superior mesenteric, and renal arteries. Ann Surg 1978 ; 188 : 404-10. 14) Pecoraro F, Pfammatter T, Mayer D et al. Multiple periscope and chimney graft to treat ruptured thoracoabdominal and pararenal aortic aneurysms. J Endovasc Ther 2011 ; 18 : 642-9. 5) Tshomba Y, Melissano G, Civilini E et al. Fate of the visceral aortic patch after thoracoabdominal aortic repair. Eur J Vasc Endovasc Surg 2005 ; 29 : 383-9. 13) Rosset E, Ahmed S, Galvaing G et al. Hybrid treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms : a multicenter retrospective study. Eur J Vasc Endovasc Surg 2014 ; 47 : 470-8. 15) Gustavo S, Mauricio R, Leonardo R et al. Endovascular repair of thoracoabdominal aortic aneurysms using fenestrated and branched endografts. J Thorac Cardiovasc Surg 2017 ; 153 : S32-41. 8) Menard MT, Nguyen LL, Chan RK et al. Thoracovisceral segment aneurysm repair after previous infrarenal abdominal aortic aneurysm surgery. J Vasc Surg 2004 ; 39 : 1163-70. 11) Kuratani T, Kato M, Shirakawa Y et al. Long-term results of hybrid endovascular repair for thoraco-abdominal aortic aneurysms. Eur J Cardiothorac Surg 2010 ; 38 : 299-304. 16) Tshomba Y, Bertoglio L, Marone EM et al. Visceral aortic patch aneurysm after thoracoabdominal aortic repair : conventional vs hybrid treatment. J Vasc Surg 2008 ; 48 : 1083-91. |
| References_xml | – reference: 6) Afifi RO, Sandhu HK, Trott AE et al. Redo thoracoabdominal aortic aneurysm repair : a single-center experience over 25 years. Ann Thorac Surg 2017 ; 103 : 1421-8. – reference: 15) Gustavo S, Mauricio R, Leonardo R et al. Endovascular repair of thoracoabdominal aortic aneurysms using fenestrated and branched endografts. J Thorac Cardiovasc Surg 2017 ; 153 : S32-41. – reference: 4) Bertoglio L, Mascia D, Cambiaghi T et al. Management of visceral aortic patch aneurysms after thoracoabdominal repair with open, hybrid, or endovascular approach. J Vasc Surg 2018 ; 67 : 1360-71. – reference: 13) Rosset E, Ahmed S, Galvaing G et al. Hybrid treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms : a multicenter retrospective study. Eur J Vasc Endovasc Surg 2014 ; 47 : 470-8. – reference: 7) Etz CD, Zoli S, Kari FA et al. Redo lateral thoracotomy for reoperative descending and thoracoabdominal aortic repair : a consecutive series of 60 patients. Ann Thorac Surg 2009 ; 88 : 758-67. – reference: 11) Kuratani T, Kato M, Shirakawa Y et al. Long-term results of hybrid endovascular repair for thoraco-abdominal aortic aneurysms. Eur J Cardiothorac Surg 2010 ; 38 : 299-304. – reference: 16) Tshomba Y, Bertoglio L, Marone EM et al. Visceral aortic patch aneurysm after thoracoabdominal aortic repair : conventional vs hybrid treatment. J Vasc Surg 2008 ; 48 : 1083-91. – reference: 3) Dardik A, Perler BA, Roseborough GS et al. Aneurysmal expansion of the visceral patch after thoracoabdominal aortic replacement : an argument for limiting patch size?. J Vasc Surg 2001 ; 34 : 405-10. – reference: 10) Black SA, Wolfe JH, Clark M et al. Complex thoracoabdominal aortic aneurysms : endovascular exclusion with visceral revascularization. J Vasc Surg 2006 ; 43 : 1081-9. – reference: 14) Pecoraro F, Pfammatter T, Mayer D et al. Multiple periscope and chimney graft to treat ruptured thoracoabdominal and pararenal aortic aneurysms. J Endovasc Ther 2011 ; 18 : 642-9. – reference: 17) Chiesa R, Tshomba Y, Melissano G et al. Hybrid approach to thoracoabdominal aortic aneurysms in patients with prior aortic surgery. J Vasc Surg 2007 ; 45 : 1128-35. – reference: 1) Crawford ES, Snyder DM, Cho GC et al. Progress in treatment of thoracoabdominal and abdominal aortic aneurysms involving celiac, superior mesenteric, and renal arteries. Ann Surg 1978 ; 188 : 404-10. – reference: 5) Tshomba Y, Melissano G, Civilini E et al. Fate of the visceral aortic patch after thoracoabdominal aortic repair. Eur J Vasc Endovasc Surg 2005 ; 29 : 383-9. – reference: 12) Tshomba Y, Melissano G, Logaldo D et al. Clinical outcomes of hybrid repair for thoracoabdominal aortic aneurysms. Ann Cardiothorac Surg 2012 ; 1 : 293-303. – reference: 2) Cruz K, LeMaire S, Weldon S et al. Thoracoabdominal aortic aneurysm repair with a branched graft. Ann Cardiothorac Surg 2012 ; 1 : 381-93. – reference: 8) Menard MT, Nguyen LL, Chan RK et al. Thoracovisceral segment aneurysm repair after previous infrarenal abdominal aortic aneurysm surgery. J Vasc Surg 2004 ; 39 : 1163-70. – reference: 9) Chiesa R, Melissano G, Civilini E et al. Two-stage combined endovascular and surgical approach for recurrent thoracoabdominal aortic aneurysm. J Endovasc Ther 2004 ; 11 : 330-3. |
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| Title | 胸腹部大動脈置換術後に生じた visceral aortic patch aneurysm に対し2期的に hybrid aortic repair を施行した1例 |
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| ispartofPNX | 日本心臓血管外科学会雑誌, 2020/11/15, Vol.49(6), pp.385-389 |
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