Novosel Luka, Perkov Dražen, Dobrota Savko, Ćorić Vedran, Štern Padovan Ranka
Department of Diagnostic and Interventional Radiology, University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia.
Department of Diagnostic and Interventional Radiology, University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia.
Ann Vasc Surg. 2014 Feb;28(2):494.e9-14. doi: 10.1016/j.avsg.2013.04.021. Epub 2013 Dec 12.
We report a case of a staged surgical and endovascular management in a 62-year-old woman with aortic coarctation associated with aortic valve stenosis and mitral regurgitation. The patient was admitted for severe aortic valve stenosis and mitral valve incompetence. During hospitalization and preoperative imaging, a previously undiagnosed aortic coarctation was discovered. The patient underwent a 2-stage approach that combined a Bentall procedure and mitral valve replacement in the first stage, followed by correction of the aortic coarctation by percutaneous placement of an Advanta V12 large-diameter stent graft (Atrium, Mijdrecht, The Netherlands) which to our knowledge has not been used in an adult patient with this combination of additional cardiac comorbidities. A staged approach combining surgical treatment first and endovascular placement of an Advanta V12 stent graft in the second stage can be effective and safe in adult patients with coarctation of the aorta and additional cardiac comorbidities.
我们报告了一例62岁女性主动脉缩窄合并主动脉瓣狭窄及二尖瓣反流的分期手术和血管内治疗病例。该患者因严重主动脉瓣狭窄和二尖瓣关闭不全入院。在住院期间及术前影像学检查时，发现了此前未诊断出的主动脉缩窄。患者接受了两阶段治疗，第一阶段联合进行了Bentall手术和二尖瓣置换术，随后在第二阶段经皮置入Advanta V12大口径支架型人工血管（荷兰米德雷赫特阿特里姆公司）矫正主动脉缩窄，据我们所知，尚未有将其用于合并此类额外心脏合并症的成年患者的报道。对于患有主动脉缩窄及其他心脏合并症的成年患者，先进行手术治疗，第二阶段再进行Advanta V12支架型人工血管的血管内置入，这种分期治疗方法可能有效且安全。
