Cho Jae Hyung, Brockenbrough Kimberly
College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:794-6. doi: 10.5761/atcs.cr.13-00067. Epub 2013 Oct 3.
Type A aortic dissection involves the ascending thoracic aorta and needs emergent surgical repair since these patients are at increased risk of complications such as aortic rupture, aortic regurgitation, myocardial infarction, and cardiac tamponade. We describe two cases of right main pulmonary artery thrombus after Type A aortic dissection repair with graft. The right main pulmonary artery thrombus is a very rare complication of Type A aortic dissection repair and has never been reported up to the present time. The preferred location of thrombus after ascending aortic dissection repair is the right main pulmonary artery due to its close approximation. The possible mechanism of right main pulmonary artery thrombus is the compression of the right main pulmonary artery by distorted aortic structure after the surgery and altered blood flow dynamics in the pulmonary artery.
A型主动脉夹层累及升主动脉,由于这些患者发生主动脉破裂、主动脉瓣反流、心肌梗死和心脏压塞等并发症的风险增加,需要紧急手术修复。我们描述了两例A型主动脉夹层修复术后右主肺动脉血栓形成的病例。右主肺动脉血栓是A型主动脉夹层修复术后一种非常罕见的并发症,迄今为止从未有过报道。升主动脉夹层修复术后血栓的好发部位是右主肺动脉,因为二者位置相近。右主肺动脉血栓形成的可能机制是术后扭曲的主动脉结构压迫右主肺动脉,以及肺动脉血流动力学改变。