Purpose: The purpose of the present study was to examine factors affecting the recovery of the physical function after abdominal aortic aneurysm (AAA) repair. Methods and Results: Fifty-eight patients underwent rehabilitation after open AAA repair. Measurements of six minute walk distance (6MWD) were obtained on the preoperative day and postoperative day 14 from April 2004 to March 2011, were included in the present study. The mean patient age was 75.3±6.4 years (53–90 years). Forty-eight of the patients were male (82.8%). The recovery ratio of 6MWD on postoperative day 14 (r6MWD) was calculated and the patients were divided into two groups: ≥90% r6MWD (Group I) and <90% r6MWD (Group D). Age and changes in weight were significantly different between groups I and D. In the logistic regression analysis, age and changes in weight were found to be significant determinants of 6MWD recovery after AAA repair. In the receiver operating characteristic analysis, the cut-off point was 72.5 years for age and -1.15 kg for weight change after AAA repair. Conclusions: Among patients who have undergone AAA repair, factors affecting recovery of physical function include age and decreases in weight.
A 74-year-old man presented with intermittent claudication in his right leg. Endovascular treatment using metallic stents was performed for occlusion of his right common iliac arterial aneurysm and right external iliac artery. Soon after endovascular treatment, the aneurysm rapidly increased in size and a diagnosis of impending rupture was made. He was treated surgically using a bifurcated graft. Metallic stenting is a risky treatment in cases with ischemia caused by thrombosed aneurysm.
In 1994, a 42-year-old woman was diagnosed with two pulmonary arteriovenous fistulas in right S3 and left S10. Coil embolization was performed for the left S10 fistula. In September 2010, chest enhanced computed tomography (CT) showed enlargement of the other fistula and recanalization of the treated fistula. Coil embolization was performed in the right S3 fistula the following year. Angiogram of left pulmonary artery displayed recanalization of the fistula in left S10. Pulmonary arteriovenous fistula may grow in natural course. In addition, recanalization after coil embolization should be noted. Therefore, regular follow-up using enhanced computed tomography is necessary.
The patient was a 41-year-old woman at 32 weeks of gestation. Six days after the Great East Japan Earthquake, she was aware of the loss of fetal movement and dyspnea. She was diagnosed with a massive acute pulmonary thromboembolism. During transport to another hospital, her delivery started and she was transferred to our hospital. Because she lost consciousness and was in shock, we introduced a percutaneous cardiopulmonary support system. Because the catheter was not effective, we decided to perform open-heart surgery. She was rescued in cooperation with some departments stuffs. In special circumstances after a disaster, it is important for lifesaving in critically ill patients for us to work together closely.
An 81 year-old man had persistent lumbar pain, abdominal pain, and abdominal distension for a week was acutely admitted to our hospital. An enhanced computed tomography scan showed a ruptured infrarenal abdominal aortic aneurysm and a left-sided inferior vena cava. We successfully performed emergency abdominal aortic reconstruction, though we needed temporary abdominal closure with a vinyl sheet for 3 days for fear of abdominal compartment syndrome. He recovered uneventfully and was discharged 27 days after surgery. Left sided inferior vena cava is a rare anomaly of the inferior vena cava and we review the relevant literature here.