Sahu Krishna Kant, Thirtha Ananda, Devgarha Sanjeev, Mathur Rajendra Mohan
Department of Cardiothoracic and Vascular Surgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India.
Ann Vasc Surg. 2011 Nov;25(8):1139.e13-5. doi: 10.1016/j.avsg.2011.05.025. Epub 2011 Aug 11.
Subclavian artery pseudoaneurysms are rare; and cases involving subclavian artery pseudoaneurysms presenting with compression on trachea leading to breathing difficulty are exceptional. We present a case report of huge subclavian artery pseudoaneurysm presenting with hoarseness of voice, respiratory distress, and aphonia. Patient was operated through median sternotomy, with the incision extended over the swelling. Aortic looping was done before opening the aneurysm. Rent in the right subclavian artery was identified and repaired. Because of the absence of a distal pulsation beyond the repaired site, we placed a reversed saphenous vein graft from the ascending aorta (end-to-side) to the right subclavian artery distal to repaired site (end-to-side). Good pulsation was achieved in the right brachial, right radial, and right ulnar arteries. Patient was extubated after 6 hours in stable condition.
锁骨下动脉假性动脉瘤较为罕见;而涉及锁骨下动脉假性动脉瘤并伴有气管受压导致呼吸困难的病例更是罕见。我们报告一例巨大锁骨下动脉假性动脉瘤病例,该患者表现为声音嘶哑、呼吸窘迫和失音。患者通过正中胸骨切开术进行手术,切口延伸至肿胀部位。在打开动脉瘤之前进行了主动脉环扎。识别并修复了右锁骨下动脉的裂口。由于修复部位远端无搏动,我们从升主动脉(端侧)至修复部位远端的右锁骨下动脉(端侧)置入了一段倒置的大隐静脉移植物。右肱动脉、右桡动脉和右尺动脉恢复了良好的搏动。患者在病情稳定6小时后拔管。