[A case of ruptured distal arch aneurysm associated with postoperative unilateral respiratory disorders]

This paper describes a patient with ruptured distal arch aneurysm associated with postoperative unilateral respiratory disorders whose life was able to be saved by surgery. The patient was a 68-year old male who underwent emergency surgery due to sealed rupture of distal arch aneurysm while preparing for selective surgery. Artificial graft replacement of the distal arch was carried out under centrifugal pump bypass. Respiration was controlled using differential lung ventilation (DLV) techniques. This was done because weaning from the respirator was difficult due to decreases in lung-thorax compliance on the opened chest side after surgery. Weaning from the respirator was achieved on the 10th day of illness after surgery. Postoperative prognosis of ruptured thoracic aneurysm is extremely poor, with high mortality being attributable to the fact that most patients are elderly and the incidence of respiratory and cardiovascular complications is very high. In addition, problems are often encountered in postoperative respiration management in patients with thoracic aneurysm who need open chest surgery. DLV seems to be a useful support in such patients who have underlying respiratory disorders.