上行大動脈人工血管置換術後の吻合部仮性瘤圧迫により人工血管狭窄を伴い心停止にいたった1例

Cardiac Arrest due to Pseudoaneurysm-induced Compression after Ascending Aortic Replacement for Stanford Type A Acute Aortic Dissection：Report of a Case

はじめに　大動脈瘤破裂や大動脈解離などの大動脈緊急症手術では，時に術後早期に再解離や吻合部仮性動脈瘤を経験する．われわれは急性大動脈解離による上行大動脈人工血管置換術後に急速に拡大した中枢側吻合部仮性瘤により，人工血管の高度狭窄を伴い心停止にいたった1例を経験したため報告する．

We present the case of a 27-year-old male who collapsed due to severe stenosis of an artificial vessel caused by a pseudoaneurysm at the central anastomotic site after acute aortic dissection Stanford type A. Although we believe that BioGlue mediated tissue toxicity may be one cause of this pseudoaneurysm, other factors, such as tissue separation due to tissue fragility caused by infection, inflammation, and cutting caused by the surgical procedure, are also thought to have contributed. Emergency re-operation was performed after resuscitation. The patient was eventually discharged home without adverse events on the 34th postoperative day. Careful observation in mid- to long-term and remote post-operative phases is necessary for patients subjected to procedures using BioGlue, and prompt repair of pseudoaneurysms is desirable.