Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
Ann Thorac Surg. 2011 Sep;92(3):1106-8. doi: 10.1016/j.athoracsur.2011.03.050.
We report a successful repair of aortic rupture after balloon angioplasty for re-coarctation using a unique approach and method. A 22-year-old woman underwent emergency surgery for aortic rupture after balloon angioplasty for postoperative aortic re-coarctation. We performed extra-anatomic bypass from the ascending aorta to the descending thoracic aorta through a median sternotomy and incision in the posterior pericardium. The transverse aortic arch was transected, and the distal aortic arch was opened under deep hypothermic circulatory arrest of the lower extremities. The proximal aorta was closed. To seal the aortic rupture site, a tube graft was inserted through the aortotomy and was oversewn with the aorta. Repair of the right ventricular outflow stenosis was concomitantly performed. The patient's postoperative course was uneventful, and she successfully gave birth 2 years postoperatively.
我们报告了一例使用独特方法成功修复球囊血管成形术后再狭窄导致的主动脉破裂。一位 22 岁女性在因术后主动脉再狭窄行球囊血管成形术后发生主动脉破裂，行急诊手术。我们经正中胸骨切开术和心包后切开，从升主动脉至降胸主动脉进行解剖外旁路。横主动脉弓被横断，在下肢深低温循环停止下打开远端主动脉弓。近端主动脉被关闭。为了封闭主动脉破裂部位，通过主动脉切开术插入一个管状移植物并用缝线与主动脉缝合。同时进行右心室流出道狭窄的修复。患者术后恢复顺利，术后 2 年成功分娩。
