[Zasshi] [Journal]. Nihon Kyōbu Geka Gakkai
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1997
Review Case Reports[Two cases of tracheal injuries secondary to blunt trauma].
We present two cases of injury to the cervical trachea and the tracheal bifurcation due to blunt trauma. A 20-year-old man sustained complete disruption of the cervical trachea during a traffic accident. He underwent end-to-end anastomosis of the disrupted trachea. ⋯ He sustained a longitudinal laceration about 3 cm from the tracheal over the membranous portion during a traffic accident. The laceration was successfully repaired by interrupted sutures with absorbable materials. Our experiences emphasize the importance of debridement of the injured cartilageous portion during treatment of tracheal injury due to blunt trauma and the difficulty in managing complete disruption of the cervical trachea with bilateral paralysis of the recurrent nerve.
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1997
[Surgical treatment of type A acute aortic dissection--experience of hypothermic circulatory arrest associated with the cerebroplegia].
From 1992 to July 1996, 19 patients (aged 39 to 78 years) were operated on for type A acute aortic dissection. Our operative strategy is that all patients in whom aortic dissection involves the segment of transverse aortic arch should undergo simultaneous replacement or repair of the aortic arch and ascending aorta. Among these 19 patients, 17 were operated on within 24 hours after onset. ⋯ One patient died of graft versus host disease (GVHD), another patient died of acute epidural hemorrhage which was undetected until the repair was completed. During the postoperative course, in all but two patients, the false lumens of the aortic arch and/or descending thoracic aorta were confirmed to be totally thrombosed by the examination of CT scan and/or aortography. It is concluded that the surgical treatment of type A acute aortic dissection can be successfully performed, even if the graft replacement extended to the transverse aortic arch.
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1997
Case Reports[Two cases of annulo-aortic ectasia with type A aortic dissection reconstructed by reimplantation of the aortic valve].
We performed aortic valve sparing operation in two cases of annulo-aortic ectasia combined with Type A aortic dissection. Marfan syndrome was found in one case and the dissection was acutely evolving in another case. ⋯ No aortic regurgitation was found in the acute case but slight regurgitation was checked out in the Marfan case at the discharge. The aortic valve preserving operation for annulo-aortic ectasia was considered much effective in cases with aortic dissection in order to expect the thrombolization in the pseudo lumen.
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Nihon Kyobu Geka Gakkai Zasshi · Apr 1997
Case Reports[A successful surgical case report of impending rupture of the true thoraco-abdominal aortic aneurysm induced by thrombosed-type acute aortic dissection (Stanford type A)].
Impending rupture of the true aneurysm of the thoraco-abdominal aorta induced by acute aortic dissection (Stanford type A) is very rare, and decision making of the therapeutic plain is difficult. A 88-year-old woman manifested severe back pain with hypotension. ⋯ Under the diagnosis of impending rupture of the thoraco-abdominal aortic aneurysm induced by acute aortic dissection (Stanford type A), graft replacement of the thoraco-abdominal aortic aneurysm and pericardial drainage were successfully performed. Two months later, computed tomographic examination revealed disappearance of the thrombosed false lumen in the ascending aorta.