Takahara Y, Sudo Y, Murayama H, Sugiura T, Sezaki T, Nakamura T
Department of Cardiovascular Surgery, Chiba Prifectural Cardio Pulmonary Center Tsurumai Hospital, Ichihara, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Nov;39(11):2084-7.
A 53-year-old woman was hospitalized with acute chest pain. A CT scan was demonstrated acute type A aortic dissection. The dissecting lumen was already closed with thrombus. A digital subtraction angiography was performed. It showed no intimal tear and a normal aortic figure. She received the medical treatment. On the fourteenth day after her admission, her both femoral arterial pulses were not palpable. A CT scan and an angiogram were performed. The new intimal tear in the ascending aorta was made, and pericardial effusion appeared. With the use of a ringed interluminal graft, an emergency operation was performed. She was discharged in good health. Some cases of early thrombogenic closure of the dissecting lumen in acute aortic dissection were reported. In a few of them, a new intimal tear developed and they lapsed into the recrudescent acute dissection. Thus, more careful medical follow up is necessary in these cases.
一名53岁女性因急性胸痛入院。CT扫描显示为急性A型主动脉夹层。夹层管腔内已形成血栓闭塞。进行了数字减影血管造影。结果显示无内膜撕裂且主动脉形态正常。她接受了药物治疗。入院第14天，双侧股动脉搏动触诊不清。进行了CT扫描和血管造影。发现升主动脉出现新的内膜撕裂，并出现心包积液。使用带环腔内移植物进行了急诊手术。她康复出院。有报道称急性主动脉夹层的夹层管腔早期可发生血栓形成性闭塞。其中少数病例会出现新的内膜撕裂，进而发展为再发急性夹层。因此，对于这些病例需要更密切的医学随访。
