外傷性腕頭動脈仮性瘤に対する開胸手術の1例

Repair of Traumatic Brachiocephalic Artery Pseudoaneurysm by Open Surgery：Report of a Case

はじめに　外傷性大動脈損傷は発生現場で死亡することが多い．腕頭動脈への鈍的外傷による仮性動脈瘤の形成はまれな疾患とされている1）．これに対する治療法として，開胸手術と血管内治療の選択にはさまざまな意見がある．われわれは，56歳・男性の外傷性腕頭動脈仮性瘤の1例を経験した．

The patient is a 56-year-old man. He fell while playing golf and sustained a contusion on his right chest. He fell into hemorrhagic shock during surgery for a right clavicle fracture at a nearby hospital and required cardiac resuscitation. Computed tomography （CT） scan revealed left pneumothorax and right hemothorax, and a contrast-enhanced CT scan revealed a pseudoaneurysm at the brachiocephalic artery origin. He underwent surgery three weeks later. Surgery was performed through a median sternotomy and partial arch replacement （zone 2） with antegrade cerebral perfusion under moderate hypothermia. He was discharged on postoperative day 10 without significant complications.