Mastroroberto Pasquale, Chello Massimo, Jannelli Gabriele, Covino Elvio
Department of Experimental and Clinical Medicine, University Magna Graecia, Viale Europa, 88100 Catanzaro, Italy.
Interact Cardiovasc Thorac Surg. 2011 Feb;12(2):202-4. doi: 10.1510/icvts.2010.256446. Epub 2010 Nov 10.
Patent false lumen after surgery for acute type A aortic dissection (AAAD) influences the outcome with increased risk of aortic rupture and visceral malperfusion. We report a case of a patient previously operated on for aortic valve repair and replacement of the ascending aorta because of AAAD, presenting at follow-up with a retrograde dissection in aortic arch, persistent patent false lumen and significative aortic enlargement. An extensive (arch and thoraco-abdominal aorta) successful repair was performed using uncovered stent grafts. We welcome discussion on the real indication of this alternative approach and advantages and disadvantages on mid-/long-term follow-up.
急性A型主动脉夹层（AAAD）手术后的假性腔持续存在会影响预后，增加主动脉破裂和内脏灌注不良的风险。我们报告一例患者，此前因AAAD接受了主动脉瓣修复和升主动脉置换手术，随访时发现主动脉弓逆行夹层、假性腔持续存在且主动脉显著扩张。使用裸支架型人工血管进行了广泛的（主动脉弓和胸腹主动脉）成功修复。我们欢迎就这种替代方法的实际适应证以及中长期随访的优缺点展开讨论。
