Nishimura Osamu, Suzuki Tomoaki, Hosoba Soh, Takashima Noriyuki, Hiramatsu Norihiko, Kinoshita Takeshi, Kambara Atsushi, Matsubayashi Keiji, Asai Tohru
Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Japan.
Kyobu Geka. 2010 Dec;63(13):1141-4.
We experienced a case of acute type A aortic dissection shortly after a cardiac operation. A 73-year-old man underwent aortic valve replacement and coronary artery bypass grafting for aortic regurgitation and angina pectoris. Aortic valve was tricuspid and the ascending aorta was mildly dilated in preoperative studies. The postoperative computed tomography (CT) revealed aortic dissection, from the ascending aorta to the arch of aorta, although the patient was asymptomatic. Reoperation for the aortic dissection was performed on the 22nd post operative day. Re-do sternotomy was safely carried out prior to heparinization. Under hypothermic circulatory arrest with femoral arterial and venous cannulations, the ascending aorta was replaced and re-implantation of the saphenous vein graft was carried out. The postoperative recovery was uneventful and he was discharged on the 17th postoperative day.
我们遇到了一例心脏手术后不久发生的急性A型主动脉夹层病例。一名73岁男性因主动脉瓣反流和心绞痛接受了主动脉瓣置换术和冠状动脉搭桥术。术前检查显示主动脉瓣为三尖瓣，升主动脉轻度扩张。术后计算机断层扫描（CT）显示主动脉夹层，从升主动脉延伸至主动脉弓，尽管患者无症状。在术后第22天对主动脉夹层进行了再次手术。在肝素化之前安全地进行了再次胸骨切开术。在股动脉和静脉插管的低温循环停止下，更换了升主动脉并进行了大隐静脉移植的重新植入。术后恢复顺利，患者于术后第17天出院。
