Surgical Repair of Left Coronary Artery Pseudoaneurysm 10 Years after a Bentall's Procudure

Bentall 수술 10년 후 발생된 좌관상동맥 가성동맥류의 수술 치료

  • Lee, Sak (Department of Cardiovascular Surgery, Shinchon Severance Hospital, Yonsei University College of Medicine) ;
  • Kang, Meyun-Shick (Department of Cardiovascular Surgery, Shinchon Severance Hospital, Yonsei University College of Medicine) ;
  • Lim, Sang-Hyun (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Chang, Byung-Chul (Department of Cardiovascular Surgery, Shinchon Severance Hospital, Yonsei University College of Medicine) ;
  • Hong, You-Sun (Department of Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine)
  • 이삭 (연세대학교 의과대학 신촌세브란스병원 흉부외과) ;
  • 강면식 (연세대학교 의과대학 신촌세브란스병원 흉부외과) ;
  • 임상현 (아주대학교 의과대학 흉부외과학교실) ;
  • 장병철 (연세대학교 의과대학 신촌세브란스병원 흉부외과) ;
  • 홍유선 (연세대학교 의과대학 영동세브란스병원 흉부외과)
  • Published : 2007.03.05

Abstract

The aortic inclusion technique is frequently used in the original Bentall's procedure for the control of excessive postoperative bleeding. Although this procedure has improved the outcome of patients with aortic root disease, there is a high incidence of both early and late complications, including coronary artery stenosis, kinking or pseudoaneurysm formation at the coronary suture lines. Pseudoaneurysm of the ascending aorta is a relatively rare, but fatal complication, which occurs after wrap-inclusion composite graft replacement. Herein, the case of a 45-year-old female, who developed a perigraft aortic pseudoaneurysm 10 years after a Bentall's procedure (wrap-inclusion technique), but was successfully managed using the Cabrol's method, is reported.

대동맥 wrap-inclusion 술식은 고유의 Bentall 수술에서 수술 후 지나친 수술의 예방을 위해 자주 사용되었다. 비록 이 수술이 대동맥근질환이 있는 환자의 경과를 향상시켰다고는 하나 관상동맥 연결부위의 관상동맥 협착, 비틀림, 가성동맥류 형성 등의 조기 및 만기 합병증의 발생률이 높은 것으로 알려져 있다. Wrap-inclusion 술식을 이용한 복합이식 후 대동맥 주위 가성동맥류 형성은 비교적 드물지만 치명적인 합병증으로 본원에서는 45세의 여자 환자에서 inclusion technique으로 Bentall수술을 받은 후 10년만에 발생한 대동맥주위 가성동맥류를 Cabrol 방법을 이용하여 성공적으로 치료하였기에 보고하는 바이다.

Keywords

References

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