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[主动脉夹层并发常染色体显性多囊肾病;病例报告]

[Thoracic aortic dissection complicating autosomal dominant polycystic kidney disease; report of a case].

作者信息

Minami Tomoyuki, Karube N, Sakamoto A

机构信息

Department of Cardiovascular Surgery, Saiseikai Yokohama City Nanbu Hospital, Yokohama, Japan.

出版信息

Kyobu Geka. 2009 Sep;62(10):924-7.

Abstract

A 55-year-old man underwent aortic valve replacement for aortic valve insufficiency 12 years ago. At that time, autosomal dominant polycystic kidney disease was diagnosed. Subsequently, renal failure developed gradually. In August 2007, the patient was admitted to the hospital because of dull back pain. Computed tomography (CT) revealed aortic dissection extending from the ascending aorta to the bifurcation of the iliac artery (Stanford type A). However, the patient had no severe symptoms associated with aortic dissection On the basis of the results of CT and blood testing, chronic aortic dissection was diagnosed. Because the patient also had chronic renal failure we decided to perform elective surgery. In January 2008, ascending aortic and aortic arch replacement with a distal elephant trunk was performed. After surgery, we were concerned about the risk of renal failure. However, the patient recovered uneventfully, without requiring dialysis. Aortic dissection can occur as a complication in patients with autosomal dominant polycystic kidney. Strict control of blood pressure is therefore essential in such patients.

摘要

一名55岁男性12年前因主动脉瓣关闭不全接受了主动脉瓣置换术。当时,诊断为常染色体显性遗传性多囊肾病。随后,逐渐发展为肾衰竭。2007年8月,患者因背部隐痛入院。计算机断层扫描(CT)显示主动脉夹层从升主动脉延伸至髂动脉分叉处(斯坦福A型)。然而,患者没有与主动脉夹层相关的严重症状。根据CT和血液检测结果,诊断为慢性主动脉夹层。由于患者同时患有慢性肾衰竭,我们决定进行择期手术。2008年1月,进行了升主动脉和主动脉弓置换并带有远端象鼻术。术后,我们担心肾衰竭的风险。然而,患者恢复顺利,无需透析。常染色体显性遗传性多囊肾病患者可能发生主动脉夹层作为并发症。因此,对此类患者严格控制血压至关重要。

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