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主动脉缩窄补片主动脉成形术后假性动脉瘤和主动脉支气管瘘

Pseudoaneurysm and aortobronchial fistula after aortic coarctation repair by patch aortoplasty.

作者信息

Posacioglu Hakan, Apaydin Anil Z

机构信息

Ege University Medical Faculty, Department of Cardiovascular Surgery Bornova, Izmir, Turkey.

出版信息

Tex Heart Inst J. 2004;31(3):319-21.

Abstract

Pseudoaneurysm and aortobronchial fistula are very rare complications of aortic coarctation repair by means of patch aortoplasty, and are usually fatal if not treated surgically. A 26-year-old man with recent-onset massive hemoptysis had undergone aortic coarctation repair by means of Dacron patch aortoplasty at the age of 10 in our hospital. Computed tomography of the chest showed a descending aortic pseudoaneurysm. Left heart bypass was used for distal perfusion while the patient underwent graft interposition. Lung parenchyma around the fistula was repaired, and the patient was discharged after an uneventful postoperative course. When hemoptysis occurs in a patient with a history of thoracic aortic surgery, aortobronchial fistula should be suspected. Close follow-up is mandatory for patients who have undergone coarctation repair.

摘要

假性动脉瘤和主动脉支气管瘘是通过补片主动脉成形术修复主动脉缩窄非常罕见的并发症,若不进行手术治疗通常会致命。一名近期出现大量咯血的26岁男性患者,10岁时在我院接受了涤纶补片主动脉成形术修复主动脉缩窄。胸部计算机断层扫描显示降主动脉假性动脉瘤。在患者接受移植物植入时,采用左心旁路进行远端灌注。瘘管周围的肺实质得到修复,患者术后恢复顺利,随后出院。有胸主动脉手术史的患者出现咯血时,应怀疑有主动脉支气管瘘。对接受过缩窄修复术的患者必须进行密切随访。

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