Choh T, Karube N, Sakamoto A
Department of Cardiovascular Surgery, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Japan.
Kyobu Geka. 2010 May;63(5):411-4.
Spontaneous rupture of the thoracic aorta is extremely rare. It is very difficult to diagnose it preoperatively.
A 71-year-old woman suffered the sudden onset of severe chest and back pain and was admitted to our hospital. Enhanced computed tomography (CT) showed mediastinal hematoma and apparent aortic dissection in the aortic arch and descending aorta. We diagnosed the rupture of Stanford type B dissection and performed an emergency operation. 20 mm tear was found in the intima of lesser curvature of aortic arch and 5 mm perforation was found in the adventitia of this part. There was no flap or false lumen suggestive of a dissection nor was there aortic aneurysm. Total aortic arch replacement was performed.
The surgery was followed by an uneventful postoperative course.
A case of spontaneous rupture of the thoracic aorta which was diagnosed the rupture of Stanford type B dissection preoperatively was successfully treated.
胸主动脉自发性破裂极为罕见。术前诊断非常困难。
一名71岁女性突发严重胸痛和背痛，被收治入院。增强计算机断层扫描（CT）显示纵隔血肿，主动脉弓和降主动脉明显主动脉夹层。我们诊断为B型夹层破裂并进行了急诊手术。在主动脉弓小弯侧内膜发现20毫米撕裂，该部位外膜发现5毫米穿孔。未见提示夹层的瓣片或假腔，也无主动脉瘤。进行了全主动脉弓置换术。
手术后病程平稳。
1例术前诊断为B型夹层破裂的胸主动脉自发性破裂病例得到成功治疗。
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