弓部大動脈りゅう手術のための落差式選択的脳冷却潅流法

• 安達 秀雄

  埼玉医科大学第1外科 自治医科大学附属大宮医療センター心臓血管外科

• 尾本 良三

  埼玉医科大学第1外科

• 横手 祐二

  埼玉医科大学第1外科

• 木村 壮介

  埼玉医科大学第1外科

• 許 俊鋭

  埼玉医科大学第1外科

書誌事項

タイトル別名

• Selective Cerebral Perfusion with Cold Blood for Repair of Aortic Arch Aneurysm.

抄録

Cerebral protection during surgical procedure of aortic arch aneurysm is one of the most important factor which limits the time of surgical repair of the aortic arch and arch branches. We introduced the selective cerebral perfusion system by gravity with cold blood for repair of aortic arch aneurysm from 1988. This study was undertaken to determine whether this new selective cold blood cerebral perfusion system is usefull for repair of aortic arch aneurysm. From July 1988 to May 1991, twenty-three patients with aortic arch aneurysms were repaired using the selective cerebral perfusion system with cold blood. Both carotid arteries were selectively perfused with oxygenated cold blood (16°C) via the reservoir combined with heat-exchanger fixed 1.5 meter high from the head of the patient. Surgical repair was performed under moderate core hypothermia (20-25°C) avoiding prolonged cardiopulmonary bypass to rewarm the patient. Cerebral perfusion pressure was 45 mmHg (mean) and perfusion flow via the carotid arteries was 400ml/min. Mean selective cerebral perfusion time was 60min and mean cardiopulmonary bypass time was 193min. Emergency operations were performed in seven of 23 patients because of ruptured aortic arch aneurysms. There was no intraoperative death. Three of 23 patients (13%) died due to postoperative complication. Nineteen of 20 survivors discharged from the hospital and are good clinical condition. One patient needs the care for rehabilitation in the hospital due to cerebral infarction. Although our experience is limited, successful cerebral protection and avoidance of prolonged cardiopulmonary bypass were achieved. Selective low pressure cerebral perfusion with cold blood may be a useful method for repair of aortic arch aneurysm.

収録刊行物

• 日本心臓血管外科学会雑誌

  日本心臓血管外科学会雑誌 22 (1), 7-13, 1993

  特定非営利活動法人 日本心臓血管外科学会

キーワード

• 弓部大動脈瘤
• 落差式選択的脳冷却灌流法
• 脳分離体外循環
• 低体温下循環停止法
• 急性大動脈解離

詳細情報

• CRID: 1390001204706088832
• NII論文ID: 130003628591
• DOI: 10.4326/jjcvs.22.7
• ISSN: 18834108
• ISSN: 02851474
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可