術後片側性呼吸障害を合併した破裂性遠位弓部大動脈瘤の1治験例

A Case of Rupture Distal Arch Aneurysm Associated with Postoperative Unilateral Respiratory Disorders

　術後片側性呼吸障害を併発した破裂性遠位弓部型大動脈瘤の1手術例を経験し，これを救命し得たので報告する．

　症例は68歳の男性で，胸部大動脈瘤の待機手術前に被包型破裂をきたしたため緊急手術が施行され，遠心ポンプバイパス下に遠位弓部の人工血管置換術を行った．術後開胸側の肺胸郭コンプライアンスが低下し，weaningが困難であったため，左右別肺換気法（DLV）により呼吸管理を行い，第10病日に人工呼吸器より離脱した．

This paper describes a patient with ruptured distal arch aneurysm associated with postoperative unilateral respiratory disorders whose life was able to be saved by surgery.

The patient was a 68-year old male who underwent emergency surgery due to sealed rupture of distal arch aneurysm while preparing for selective surgery. Artificial graft replacement of the distal arch was car-ried out under centrifugal pump bypass. Respiration was controlled using differential lung ventilation (DLV) techniques.