{"created":"2021-03-01T06:16:52.508638+00:00","id":12590,"links":{},"metadata":{"_buckets":{"deposit":"5d52462d-46de-4062-8f90-14a893ed3e22"},"_deposit":{"id":"12590","owners":[],"pid":{"revision_id":0,"type":"depid","value":"12590"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00012590","sets":["453:456","471:537:538:1028"]},"item_7_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Combined Off-pump Coronary Artery Bypass Grafting and Abdominal Aortic Aneurysm Repair"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2005-04","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"4","bibliographicPageEnd":"256","bibliographicPageStart":"251","bibliographicVolumeNumber":"119","bibliographic_titles":[{"bibliographic_title":"新潟医学会雑誌"},{"bibliographic_title":"新潟医学会雑誌","bibliographic_titleLang":"en"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"狭心症(AP)と腹部大動脈瘤(AAA)を同時に有する症例は稀でない.このような症例に対して,従来冠動脈バイパス術(CABG)とAAA reoairは二期的に行われることが多かった.また一期的同時手術は手術侵襲が過大ゆえ,その適応は限定されてきた.しかし体外循環非使用心拍動下冠動脈バイパス術(OPCAB)の導入で,同時手術はその侵襲が低減し,適応を拡大できる可能性がある.【目的】当科でのOPCAB+AAA reoair同時手術の成績からその妥当性を検討した.【対象】2000年1月から2004年8月までに当科で施行したOPCAB+AAA reoair同時手術9例(男:女=9:0,年齢61～78歳,平均70.4±6.3歳)を対象にした.冠動脈病変の内訳は2枝病変4例,3枝病変1例,左冠動脈主幹部を含むもの4例であった.AAA径は5.5～10.0cm,平均7.0±1.6cmであった.【手術】胸骨正中切開によるOPCABの後,腹部正中切開・開腹法によるAAA reoairを行った.【結果】手術時間は365～645分,平均499.7±107.8分,バイパス数は1～4本,平均2.4±0.9本であった.使用グラフトの内訳は,左内胸動脈7例(sequential bypassを1例含む),右内胸動脈3例,右胃大網動脈1例,橈骨動脈1例,大伏在静脈5例(sequential bypassを1例含む)であった.体外循環下CABGへの移行はなかった.Amreoairは全例Y型人工血管置換術で,1例に片側内腸骨動脈の再建,1例に片側内腸骨動脈と下腸間膜動脈の再建を要した.集中治療室管理は38～136時間,平均63±41時間で,食事は3～9病日,平均4.9±1.8病日に開始できた.術後在院期間は12～54日,平均24.0±12.3日であった.在院死はなかった.合併症は大伏在静脈採取部の創感染1例,開腹創MRSA感染1例,下肢動脈血栓症1例,遅発性心タンポナーデ1例計4例に発生したが,全例後遺症なく治癒した.術後遺影でグラフト末梢側吻合合計22箇所はすべて開存していた.【結語】OPCAB+AAA reoair同時手術の成績は満足できる内容であった.本法は,二期的手術に伴うリスクの回避,治療期間の短縮などの長所もあり,APを合併したAAAの治療として妥当である.","subitem_description_type":"Abstract"}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会"}]},"item_7_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"publisher"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"00290440","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"青木, 賢治"}],"nameIdentifiers":[{"nameIdentifier":"83897","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"杉本, 努"}],"nameIdentifiers":[{"nameIdentifier":"83898","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"山本, 和男"}],"nameIdentifiers":[{"nameIdentifier":"83899","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"桑原, 淳"}],"nameIdentifiers":[{"nameIdentifier":"83900","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"吉井, 新平"}],"nameIdentifiers":[{"nameIdentifier":"83901","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"春谷, 重孝"}],"nameIdentifiers":[{"nameIdentifier":"83902","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-07"}],"displaytype":"detail","filename":"KJ00004300726.pdf","filesize":[{"value":"976.7 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"KJ00004300726.pdf","url":"https://niigata-u.repo.nii.ac.jp/record/12590/files/KJ00004300726.pdf"},"version_id":"63adcf9e-c3f8-40b4-a7e4-16ba12e58a3d"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"腹部大動脈瘤","subitem_subject_scheme":"Other"},{"subitem_subject":"狭心症","subitem_subject_scheme":"Other"},{"subitem_subject":"冠動脈バイパス術","subitem_subject_scheme":"Other"},{"subitem_subject":"OPCAB","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"狭心症を合併した腹部大動脈瘤に対する同時複合手術","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"狭心症を合併した腹部大動脈瘤に対する同時複合手術"},{"subitem_title":"狭心症を合併した腹部大動脈瘤に対する同時複合手術","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","1028"],"pubdate":{"attribute_name":"公開日","attribute_value":"2007-05-10"},"publish_date":"2007-05-10","publish_status":"0","recid":"12590","relation_version_is_last":true,"title":["狭心症を合併した腹部大動脈瘤に対する同時複合手術"],"weko_creator_id":"1","weko_shared_id":null},"updated":"2022-12-15T03:45:22.212481+00:00"}