Moura Marcelo R L, Melissano Germano, Maisano Francesco, Marone Enrico M, Civilini Efrem, Alfieri Ottavio, Chiesa Roberto
Department of Vascular Surgery, Università Vita-Salute, IRCCS H. San Raffaele, Milan, Italy.
Vasc Endovascular Surg. 2002 Jul-Aug;36(4):305-9. doi: 10.1177/153857440203600409.
Endovascular intervention is an alternative form of treatment for patients with thoracic aortic aneurysms. Coexistent cardiovascular diseases may adversely influence the postoperative course and affect the long-term prognosis. The case of a 76-year-old man with severe coronary artery disease and a thoracic aortic aneurysm is reported. A single-stage procedure of off-pump coronary artery revascularization and endoluminal exclusion of the descending thoracic aortic aneurysm was performed. The patient was treated first with off-pump coronary artery bypass graft (left internal mammary artery on the left anterior descending coronary artery and two single venous grafts from ascending aorta to obtuse marginal artery and posterior descending artery). After heart revascularization, two Thoracic Excluder endovascular grafts (34 x 100 and 37 x 100 mm) were implanted to treat the descending thoracic aortic aneurysm. Follow-up with computed tomography angiography showed successful exclusion of the thoracic aneurysm 12 months after the procedure. The patient is well and free of symptoms 18 months later.
血管内介入治疗是胸主动脉瘤患者的一种替代治疗方式。并存的心血管疾病可能会对术后病程产生不利影响，并影响长期预后。本文报道了一例76岁患有严重冠状动脉疾病和胸主动脉瘤的男性患者。实施了非体外循环冠状动脉血运重建和胸降主动脉瘤腔内隔绝的一期手术。患者首先接受了非体外循环冠状动脉旁路移植术（左乳内动脉至左前降支冠状动脉，以及两根从升主动脉至钝缘支动脉和后降支动脉的单根静脉移植物）。心脏血运重建后，植入了两枚Thoracic Excluder血管内移植物（34×100和37×100毫米）以治疗胸降主动脉瘤。术后12个月的计算机断层扫描血管造影随访显示胸主动脉瘤成功隔绝。18个月后患者情况良好，无症状。
