Fukushima K, Yamaguchi T, Take A, Kamisawa O, Misawa Y, Hasegawa T
Department of Thoracic and Cardiovascular Surgery, Jichi Medical School, Tochigi, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Dec;40(12):2232-5.
A 59-year-old farmer was admitted with severe anterior chest and back pain. As MRI showed a Stanford type A dissection, operation was performed. Surgical intervention revealed the clotted false lumen of the ascending aorta without intimal tear, and it was transected and primarily reconstructed with Teflon felt bolsters. Three months later MRI disclosed disappearance of the dissected lumen in the ascending and descending aorta. During the following two years and three months, a saccular aneurysm of the distal arch was found to be increased in size rapidly. The second operation was attempted to close the intimal defect with patch. As a whole this was a rare case of DeBakey type III acute aortic dissection complicated with proximal extension, clotted false lumen and saccular aneurysm formation at the site of the intimal tear.
一名59岁的农民因严重的前胸和背部疼痛入院。磁共振成像（MRI）显示为斯坦福A型主动脉夹层，遂进行了手术。手术干预发现升主动脉的假腔已形成血栓，无内膜撕裂，将其横断并使用特氟龙毡垫进行一期重建。三个月后，MRI显示升主动脉和降主动脉的夹层腔消失。在接下来的两年零三个月里，发现主动脉弓远端的一个囊状动脉瘤迅速增大。尝试进行第二次手术，用补片封闭内膜缺损。总体而言，这是一例罕见的德巴基III型急性主动脉夹层，合并近端扩展、假腔血栓形成以及内膜撕裂部位的囊状动脉瘤形成。
