右肺出血を合併したStanford A型急性大動脈解離の1例

Stanford Type A Acute Aortic Dissection Complicated by Right Lung Hemorrhage：Report of a Case

はじめに　急性大動脈解離の出血性合併症として心タンポナーデは一般的であるが，肺出血の合併は比較的まれである．われわれは，偽腔が血栓閉塞したStanford A型急性大動脈解離（AAD）に右肺出血を合併した症例を経験したので報告する．

A 59-year-old woman was transferred to our hospital because of a sudden onset of chest and back pain. Computed tomography （CT） demonstrated Stanford type A acute aortic dissection with cardiac tamponade and right airway bleeding. Hemorrhage from ruptured false lumen extended along the pulmonary artery （PA）, compression of the right PA were recognized due to hematoma surrounding the PA. An emergency operation was performed. The primary tear was located at the distal aortic arch, and total arch replacement with frozen elephant trunk was performed. During the operation, she had airway bleeding. The bleeding was thought to be due to the hematoma extending along the pulmonary artery. She was extubated 7th postopratively. She was discharged 44 days after the operation.