Kuki S, Taniguchi K, Miyagawa S, Takano H
Department of Cardiovascular Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Sakai, Japan.
Eur J Cardiothorac Surg. 2000 May;17(5):614-6. doi: 10.1016/s1010-7940(00)00390-0.
Although a right-sided aortic arch is not a rare anomaly, an aortic dissection involving an isolated right-sided aortic arch is extremely rare and remains a complicated entity for surgical therapy because of its anatomical characteristics. Previous reports that we have identified in English literature include only six surgical cases of aortic dissection involving a right-sided aortic arch. We report on a 75-year-old female who had a chronic thoracoabdominal aortic aneurysm following type B aortic dissection in a right-sided aortic arch. Graft replacement including reconstruction of Adamkiewicz artery and a celiac trunk was performed. The postoperative course was uneventful except for a prolonged ventilatory support. This case seems to be the first successful case of extended graft replacement for this pathology.
虽然右侧主动脉弓并非罕见的异常情况，但累及孤立性右侧主动脉弓的主动脉夹层极为罕见，并且由于其解剖学特征，对于外科治疗而言仍是一个复杂的实体。我们在英文文献中找到的既往报告仅包括6例累及右侧主动脉弓的主动脉夹层手术病例。我们报告了一名75岁女性，其在右侧主动脉弓发生B型主动脉夹层后出现慢性胸腹主动脉瘤。实施了包括重建Adamkiewicz动脉和腹腔干的移植物置换术。术后病程平稳，只是通气支持时间延长。该病例似乎是首例针对这种病变成功实施扩大移植物置换术的病例。
