Surgical Treatment Of Thoracic Aortic Aneurysm (One Case Report)

The patient,male,70 years old,retired worker,because of left lumbag 4 hours.chest pain 3 hours,was in hospital.The patient felt pain in the left lumbar region.It's nature was continuedagony,with dripping sweat.one hour later,he felt tearing pain in his thoracic region without the symptoms of panicky,chest distress,accelerated breathing, nausea or omitting etc.So he was been in our hospital by someone.After hospitalization,according to history,clinical physical examination and results of ECGchest X-ray and chest CT,he was finally diagnosed as thoracic dissection aortic aneurysm,hypertension grade 3,Cardiac function grade II. Physical examination showed:T 37.0℃,BP 160/100mmHg,R 22bpm,P 78 bpm.The patient's mind was awake with body position free.He was cooperated with our physical examination.his superficial lymphoid node was not intumescence.He was isocoria.It's reflex of light existed.His albuginea oculi wasn't stained yellow.The trachea was in the middle of cervical part. The jugular vein was not distending.The compaign of thorax was symmetry.The mobility of left thorax was attenuated.His left thorax's breath sound was low and accompanyed with bubble.His boundary of left Cardiac dullness was enlarged.His apical impulse was normal.P 78 bpm.There was II/6Gsm in his left limit of sternal border,without conduction.His abdomen was evenness and soft.His liver and spleen were not touched intumesced.His bowel sound was attenuated.There was no vascular murmur in his abdominal region.His percussion tenderness over left renal region was positive.There was no abnormalities and active handicap in his back bone and limbs.His BLE were not swelling.His ADP was touched,but the left impulse was poorer than the right one.His nervous reflex was normal.The result of laboratory datas showed:URT: BIL3+, PRO3+, BLD3+, BRT: RBC 3.88 X 1012/L,WBC 16.4 X 109 /L, N 83.3%.After hospitalization,his blood MHb,TN,CK was checked three times,the results showed his MHb was high,but the other two were normal.The results of all lead ECG showed STand ST-T were normal,the swing of V5, V6's R wave were decreased and q wave and Q wave were found in V7, V8 and V9.The first ECG showed LVH.Chest CT showed the patient's left lung was collapsed,mediastinum and heart shadow were migrated toward left sidedness.lt was thus clear that DA wasdivided into two cavea with inequality of size.Chest X-ray showed left cardiac border was not disclosed,mediastinum superior shadow widened.After preoperative preparation,the patient's descending aorta dissecting aortic aneurysm was permutated in omni-anesthesia and left heart bypass.In the operation,we incised descending aorta aneurysm," 8 "character sutured intercostal artery and lastly permutated artificial blood vessel.The operation went on successfully.Post-operation the patient was received routinely disposal of hemostasia,anti-inflammation,augmentate cardiac function, diuresis etc and recoveried unevenly.He discharged in 2003.8.25.