Yoshizumi T, Ito T, Nakayama M, Abe T, Hagiwara H, Kawamura A, Sunada M
Department of Cardiovascular Surgery, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
Kyobu Geka. 2009 Dec;62(13):1170-3.
We report a case of surgical treatment for ascending aortic aneurysm and aortic valve regurgitation (AR) 24 years after operative repair of coarctation of the aorta (CoA). The patient was a 32-year-old man who had undergone operative repair of CoA and patent ductus arteriosus (PDA) ligation when 8 years old, and was followed since then. However, since 14 years after the operation, dilation of his ascending aorta and AR was observed. Then the AR deteriorated and the ascending aorta dilated, and at 24 years after operation he had symptoms of heart failure. So we performed ascending aorta replacement and aortic root replacement (reimplantation). Despite primary success of the operative repair of CoA, however. 9% of patients develop aortic aneurysms long after the operation. Therefore, long-term follow-up is needed after repair of coarctation of the aorta.
我们报告了一例在主动脉缩窄(CoA)手术修复24年后,对升主动脉瘤和主动脉瓣反流(AR)进行外科治疗的病例。患者为一名32岁男性,8岁时接受了CoA手术修复和动脉导管未闭(PDA)结扎术,此后一直接受随访。然而,自手术后14年起,观察到其升主动脉扩张和AR。随后AR恶化,升主动脉进一步扩张,在手术后24年,他出现了心力衰竭症状。于是我们进行了升主动脉置换和主动脉根部置换(再植入)。尽管CoA手术修复取得了初步成功,然而,9%的患者在手术后很长时间会发生主动脉瘤。因此,主动脉缩窄修复术后需要进行长期随访。