偽腔血栓閉塞により真腔閉塞をきたした急性大動脈解離の1例

Acute Aortic Dissection with True Lumen Occlusion Due to False Lumen Thrombosis：Report of a Case

はじめに　臓器灌流障害を伴う急性大動脈解離に対する手術成績は，それを伴わない場合と比較して死亡率が高いと報告されている1，2）．近年，弓部大動脈治療においてオープン型ステントグラフト内挿術（frozen elephant trunk：FET）が登場し，急性大動脈解離に対する弓部以遠のcentral repairに対しても治療成績の向上に効果的と考えられ，普及してきた．

The surgical outcomes for acute aortic dissection with malperfusion have been reported to have a higher mortality rate compared to that without malperfusion. In recent years, the use of the frozen elephant trunk （FET） technique, has emerged for the treatment of aortic diseases. It is considered to be effective in improving treatment outcomes for central repair beyond the arch in acute aortic dissection cases. We present a case in which total arch replacement using FET was performed for acute aortic dissection with severe narrowing to occlusion of the true lumen below the aortic arch due to false lumen thrombosis. In cases of acute type A aortic dissection with malperfusion, there is still debate regarding whether ischemic relief or central repair should be prioritized. We report on the factors contributing to the successful outcome in this case a long with a literature review.