[Surgical treatment for a patient with respiratory failure due to annulo-aortic ectasia and aortic arch aneurysm]

It is not always easy to determine the causes of preoperative respiratory failure when either cardiac failure due to annuloaortic ectasia (AAE) or compression of the bronchus by aortic arch aneurysm are involved. A 64-year-old man was admitted to the emergency room of our hospital because of dyspnea and disturbance of consciousness. The findings of chest X-ray, UCG and CT scan on admission revealed AAE and aortic arch aneurysm, so we performed an emergency operation using Bentall's procedure. In spite of improvement of the cardiac failure after operation, hypercapnemia still remained, which was considered to be due to compression of the bronchus by the aortic arch aneurysm. Therefore, at the second stage, resection and replacement of the aortic arch aneurysm was performed with the aid of selective cerebral perfusion. After this operation, he could be weaned from the respirator.