Nishimoto Masayoshi, Hazui Hiroshi, Hamori Kan, Fukumoto Hitoshi
Department of Thoracic and Cardiovascular Surgery, Osaka Mishima Emergency and Critical Care Medical Center, 11-1 Minami Akutagawa-cho, Takatsuki City, Osaka 569-1124, Japan.
Interact Cardiovasc Thorac Surg. 2005 Dec;4(6):543-5. doi: 10.1510/icvts.2005.105783. Epub 2005 Aug 5.
The patient was a 54-year-old male who suddenly noted severe back pain while eating. A diagnosis of acute type A aortic dissection was made on contrast enhanced CT. As a result, emergency surgical repair was performed on the same day. Through median sternotomy, graft replacement of the ascending aorta, including removal of the site of the intimal tear, was carried out under deep hypothermia and retrograde cerebral perfusion. Although the postoperative course was satisfactory, the patient complained of severe chest pain with ECG change on the 23rd postoperative day. Emergency coronary angiography revealed the presence of wide coronary artery dissection from an entry of the left anterior descending aorta (LAD) to a reentry of the left circumflex artery (LCX). Multiple stents were implanted in the LAD and LCX. After stenting, chest symptoms were relieved, and ECG change disappeared. He was discharged from our hospital on the 42nd postoperative day.
该患者为一名54岁男性，进食时突然感到严重背痛。经增强CT检查诊断为急性A型主动脉夹层。因此，于同日进行了急诊手术修复。通过正中胸骨切开术，在深低温和逆行脑灌注下，进行了升主动脉移植置换，包括切除内膜撕裂部位。尽管术后过程顺利，但患者在术后第23天出现严重胸痛并伴有心电图改变。急诊冠状动脉造影显示，从左前降支主动脉（LAD）入口到左旋支动脉（LCX）再入口存在广泛的冠状动脉夹层。在LAD和LCX中植入了多个支架。支架置入后，胸部症状缓解，心电图改变消失。患者于术后第42天出院。
