J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 3407KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 98(5): 524-528, 1997

Case report

A SUCCESSFUL SURGICAL TREATMENT OF DISSECTING THORACOABDOMINAL AORTIC ANEURYSM USING A HEPARIN COATED PERCUTANEOUS CARDIOPULMONARY SUPPORT SYSTEM

1) Second Department of Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
2) Department of Cardiovascular Surgery, Nikko Memorial Hospital, Muroran, Japan

Hisashi Tanaka2), Akihito Yanagiya1), Teruhisa Kazui2)

A 52-year-old man with dissecting thoracoabdominal aortic aneurysm (impending rupture) involving the celiac, superior mesenteric and reanl arteries underwent graft replacement of the thoracoabdominal aorta with reconstruction of all visceral branches and intercostal arteries (Th11, 12) with the aid of femoro-femoral bypass. The bypass was performed using a heparin coated percutaneus cardiopulmonary support system with low doses of heparin, maintaining activated coagluation time at about 300 seconds. During the reconstruction of the major visceral branches, the branches were separately cannulated from inside the aorta, and perfused selectively via partial extracorporeal circulation. The intercostal arteries were reconstructed segmentaly to minimize the duration of ischemia. During the repair of the intercostal arteries, Fogarty balloon catheters were inserted into the intercostal arteries to prevent back bleeding and ischemia. The patient had a satisfactory postoperative course.

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