Graft Replacement with Partial Extra-corporeal Circulation of Descending Thoracic and Abdominal Aortic Aneurysms in Marfan Syndrome Combined with Severe Left Ventricular Dysfunction and Mitral Regurgitation
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- Sugiyama Kayo
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital
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- Matsuyama Katsuhiko
- Department of Cardiovascular Surgery, Aichi Medical University Hospital
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- Koizumi Nobusato
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital
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- Maruno Keita
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital
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- Muromachi Yukio
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital
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- Iwahori Akinari
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital
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- Takahashi Satoshi
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital
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- Iwahashi Toru
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital
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- Nishibe Toshiya
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital
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- Ogino Hitoshi
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital
Bibliographic Information
- Other Title
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- 重症心不全を伴ったマルファン症候群に対する部分体外循環補助下胸部下行大動脈置換術および腹部大動脈置換術
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Abstract
<p>We report on a rare case of Marfan syndrome with giant dissecting descending thoracic and abdominal aortic aneurysms associated with poor left ventricular function and severe mitral regurgitation. Before the anesthetic induction, a partial extra-corporeal circulation was established to prevent a collapse of the circulation. Descending aortic graft replacement and following abdominal aortic graft replacement were performed safely using the partial extra-corporeal circulation to relief the afterload for the severely deteriorated left ventricle with severe mitral regurgitation. Intra-aortic balloon pumping was also promptly used to assist the poor circulation in the postoperative period. Despite the admission to a specialized institute, he died from irreversible heart failure with a developing renal failure. Even for a difficult patient with Marfan syndrome with severe left ventricular dysfunction and mitral regurgitation, graft replacement was feasible with meticulous perioperative circulatory management using partial extra-corporeal circulation and intra-aortic balloon pumping. However, a prompt registration for heart transplantation and an aortic surgery concomitant with implantation of left ventricular assisted device should have been considered to save the patient.</p>
Journal
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- Japanese Journal of Cardiovascular Surgery
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Japanese Journal of Cardiovascular Surgery 47 (2), 71-77, 2018
The Japanese Society for Cardiovascular Surgery
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Keywords
Details 詳細情報について
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- CRID
- 1390282679684348032
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- NII Article ID
- 130006619218
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- ISSN
- 18834108
- 02851474
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed