Tochii Masato, Ando Motomi, Takagi Yasushi, Kaneko Kan, Ishida Michiko, Akita Kiyotoshi, Higuchi Yoshiro
Department of Cardiovascular Surgery, Fujita Health University, Toyoake, Japan.
Ann Thorac Cardiovasc Surg. 2010 Dec;16(6):451-3.
Cardiac surgical procedure and catheter intervention of the aorta or its major branches have a potential risk for iatrogenic aortic dissection. This case demonstrates an iatrogenic type A aortic dissection after the elective balloon angioplasty for severe stenosis of the left subclavian artery orifice. The dissection retrospectively extended to the ascending aorta, and intramural hematoma was observed in the false lumen of the aorta. The ascending aorta was successfully replaced 14 days after the occurrence of dissection, using hypothermic circulatory arrest and antegrade selective cerebral perfusion. There were no outstanding complications.
心脏外科手术以及主动脉或其主要分支的导管介入治疗存在医源性主动脉夹层的潜在风险。本病例展示了一例在择期对左锁骨下动脉开口严重狭窄进行球囊血管成形术后发生的医源性A型主动脉夹层。该夹层经回顾性分析已延伸至升主动脉，且在主动脉假腔内观察到壁内血肿。夹层发生14天后，采用低温循环停搏和顺行性选择性脑灌注，成功实施了升主动脉置换术。未出现明显并发症。
