Nasu M, Shimpo H, Tanaka K, Mizutani T, Yada I, Kusagawa M
Department of Thoracic Surgery, Mie Medical College, Tsu, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Jan;38(1):146-9.
Atresia of aortic arch (AAA) is very rare congenital anomaly and hemodynamically comparable with interruption of aortic arch (IAA). In general it is associated with pulmonary-ductus descending aorta trunk (PDDT) and its prognosis is extremely poor. 38-year old man complained of easy fatigability and hypertension on bilateral arms. Aortography showed interruption of blood stream at aortic isthmus and rich collateral blood flow to descending aorta. PDDT or intracardiac anomaly was not found. He was diagnosed IAA, type A of Celoria-Patton without PDDT. Alternatively echocardiography and magnetic resonance imaging revealed the anatomical continuity between the aortic arch and the descending aorta. Therefore he was finally diagnosed aortic arch atresia without PDDT. The prosthetic bypass grafting was performed between left subclavian artery and descending aorta.
主动脉弓闭锁(AAA)是一种非常罕见的先天性异常,在血流动力学上与主动脉弓中断(IAA)相似。一般来说,它与肺动脉导管降主动脉干(PDDT)相关,其预后极差。一名38岁男性主诉双侧手臂易疲劳和高血压。主动脉造影显示主动脉峡部血流中断,降主动脉有丰富的侧支血流。未发现PDDT或心内异常。他被诊断为无PDDT的Celoria-Patton A型IAA。另外,超声心动图和磁共振成像显示主动脉弓与降主动脉之间存在解剖连续性。因此,他最终被诊断为无PDDT的主动脉弓闭锁。在左锁骨下动脉和降主动脉之间进行了人工血管搭桥术。