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成人主动脉弓中断的单阶段解剖外修复术

Interrupted aortic arch in an adult single-stage extra-anatomic repair.

作者信息

Messner Greg, Reul George J, Flamm Scott D, Gregoric Igor D, Opfermann Ulrich Tim

机构信息

Department of Cardiovascular Surgery, Texas Heart Institute at St Luke's Episcopal Hospital, Houston 77030, USA.

出版信息

Tex Heart Inst J. 2002;29(2):118-21.

Abstract

Interrupted aortic arch is a rare congenital malformation of the aortic arch that occurs in 3 per million live births. Defined as a loss of luminal continuity between the ascending and descending portions of the aorta, this anomaly entails a very poor prognosis without surgical treatment. To our knowledge, the world medical literature contains only 12 reports of isolated interrupted aortic arch diagnosed in adults. Nine of these patients underwent successful surgical repair, but 1 died during the early postoperative period. We describe a 10th successful surgical repair, which involved a 42-year-old woman who had an asymptomatic type B interrupted aortic arch (characterized by interruption between the left subclavian and left carotid arteries). We performed a single-stage extra-anatomic repair by placing a 16-mm extra-anatomic Dacron graft between the ascending and descending portions of the thoracic aorta and by interposing a 7-mm extra-anatomic Dacron graft between the 16-mm graft and the left subclavian artery. The patient recovered uneventfully and continued to do well 6 months later.

摘要

主动脉弓中断是一种罕见的主动脉弓先天性畸形,每百万活产儿中发生率为3例。该畸形定义为主动脉升部和降部之间管腔连续性丧失,若不进行手术治疗,预后极差。据我们所知,世界医学文献中仅有12例成人孤立性主动脉弓中断的报道。其中9例患者手术修复成功,但1例在术后早期死亡。我们描述了第10例成功的手术修复,患者为一名42岁女性,患有无症状B型主动脉弓中断(其特征为左锁骨下动脉和左颈动脉之间中断)。我们通过在胸主动脉升部和降部之间放置一个16毫米的解剖外涤纶移植物,并在16毫米移植物与左锁骨下动脉之间插入一个7毫米的解剖外涤纶移植物,进行了单阶段解剖外修复。患者恢复顺利,6个月后情况良好。

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本文引用的文献

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Complete interruption of the aortic arch in adults.
Radiology. 1973 Jan;106(1):53-7. doi: 10.1148/106.1.53.

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