The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Hybrid Approach for Thoracic Aortic Arch Aneurysms in Two Patients at High Operative Risk

고위험군 대동맥궁 동맥류에 대동맥 상부 혈관 우회술과 스텐트 그라프트 치료 2예

  • Jang, Se Won (Department of Internal Medicine, Good Samsun Hospital) ;
  • Ko, Woo Seok (Department of Internal Medicine, Good Samsun Hospital) ;
  • Kim, Min Jeong (Department of Internal Medicine, Good Samsun Hospital) ;
  • Choi, Jung Cheon (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Ahn, Jin Hee (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Song, Seung Hwan (Department of Thoracic & Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Lee, Han Cheol (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine)
  • 장세원 (좋은삼선병원 내과) ;
  • 고우석 (좋은삼선병원 내과) ;
  • 김민정 (좋은삼선병원 내과) ;
  • 최정천 (부산대학교 의학전문대학원 부산대학교병원 순환기내과) ;
  • 안진희 (부산대학교 의학전문대학원 부산대학교병원 순환기내과) ;
  • 송승환 (부산대학교 의학전문대학원 부산대학교병원 흉부외과) ;
  • 이한철 (부산대학교 의학전문대학원 부산대학교병원 순환기내과)
  • Received : 2012.11.27
  • Accepted : 2013.03.18
  • Published : 2014.02.01
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Abstract

A large aortic aneurysm invading the aortic arch can be catastrophic if rupture occurs. In the past, the standard treatment was an open thoracotomy followed by total aortic arch replacement. However, open surgery is difficult in patients at high operative risk. Consequently, thoracic endovascular aortic repair (TEVAR) is preferred in high-risk patients. In patients with a short proximal landing whose aortic aneurysm invades the aortic arch, TEVAR is not available because of innominate, left carotid, and left subclavian artery occlusion. We report two cases in which aortic aneurysms invaded the aortic arch, and who were treated with TEVAR after a supra-aortic artery bypass operation.

연령이 높고 수술 고위험군인 대동맥궁의 대동맥류에 대해 대동맥궁 상부동맥 우회술과 스텐트 이식편(stent-graft) 삽입을 같이 시행하는 Hybrid 수술을 시행하여 좋은 결과를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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