Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Aortic Arch Aneurysm Repair using a Prosthetic Graft with a Pre-mounted Distal Stent (Frozen Elephant Trunk)

원위부에 스텐트가 포함된 인조혈관 (Frozen Elephant Trunk)을 이용한 대동맥궁 동맥류 수술

  • Chang, Hyoung-Woo (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Chung, Eui-Suk (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Choi, Jin-Ho (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Lim, Cheong (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Park, Kay-Hyun (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
  • 장형우 (분당서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학교실) ;
  • 정의석 (분당서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학교실) ;
  • 최진호 (분당서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학교실) ;
  • 임청 (분당서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학교실) ;
  • 박계현 (분당서울대학교병원 흉부외과, 서울대학교 의과대학 흉부외과학교실)
  • Published : 2009.06.05
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Abstract

Difficulty in exposing anastomotic sites is a frequently encountered problem during surgical repair of a distal aortic arch aneurysm via median sternotomy or lateral thoracotomy. Endovascular repair has th limitation that it usually requires surgical rerouting of some of the brachiocephalic branches in order to get sufficient length for proximal fixation of the stent-graft. To take advantage of each approach, we fixed the distal end of the prosthetic graft by means of a pre-mounted metallic stent instead of performing conventional surgical anastomosis during the repair of distal arch aneurysms with using median sternotomy and hypothermic circulatory arrest. We report here on our experience with such 3 patients.

원위부 대동맥궁에 발생한 대동맥류에 대한 수술을 위해서는 정중흉골 절개술 또는 측방개흉을 통한 수술방법이 있으나 문합 부위의 시야 확보가 용이하지 않은 경우가 자주 있다. 수술 대신 중재시술로 스텐트 그라프트를 삽입하는 방법 또한 가능하지만 동맥류보다 근위부에 충분한 고정 거리를 확보하기 위해서 대동맥궁 분지 일부를 결찰하고 우회로를 조성해야 할 필요가 있다는 제한이 있다. 저자들은 이들 방법의 장점을 취하고자 정중흉골절개술 후 완전 순환 정지 상태에서 대동맥궁을 치환하는 수술 중 외과적 문합 대신 스텐트 그라프트를 이용하여 인조혈관 원위부를 고정하는 방법을 취하여 양호한 결과를 얻은 경험을 보고한다.

Keywords

References

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