下肢虚血を合併した Stanford B 型急性大動脈解離に対する人工血管置換術後 MNMS の救命例
書誌事項
- タイトル別名
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- Successful Open Graft Replacement for Acute Stanford Type B Aortic Dissection with Bilateral Lower Limb Ischemia and Postoperative Myonephropathic Metabolic Syndrome
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A 52-year-old man suddenly felt severe back pain and numbness in the lower extremities. Enhanced CT revealed an acute Stanford type B dissection. The true lumen of the left common iliac artery was severely compressed by the thrombosed false lumen. We performed a femoro-femoral bypass and symptoms in the lower limbs disappeared. On day 4 of hospitalization, the patient suddenly presented with pain at rest and cyanosis in both lower extremities. CT revealed nearly total occlusion of the abdominal aorta due to severe compression of the false lumen. We performed emergency open graft replacement in the infrarenal aorta. Although ischemia in the lower extremities improved, the patient developed myonephropathic metabolic syndrome (MNMS) and received continuous hemodiafiltration to treat acute renal insufficiency. The patient's ankle-branchial pressure index improved and he was weaned from continuous hemodiafiltration. The patient had no paralysis and was able to walk unassisted, so he was discharged on day 34 of hospitalization. In the event of acute aortic dissection and organ ischemia, emergency open graft replacement may be required and must be performed promptly as a lifesaving measure.
収録刊行物
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- 日本心臓血管外科学会雑誌
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日本心臓血管外科学会雑誌 42 (1), 50-53, 2013
特定非営利活動法人 日本心臓血管外科学会
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詳細情報 詳細情報について
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- CRID
- 1390001204707773184
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- NII論文ID
- 130004548430
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- ISSN
- 18834108
- 02851474
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
- Crossref
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可