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升主动脉置换术后缝线处假性动脉瘤的血管内支架移植物修复术。

Endovascular stent graft repair of suture-line pseudoaneurysm following ascending aorta replacement.

作者信息

Zicho David, Cartwright Neil, Bizzarri Federico, Malkin Christopher, Cross Michael, Mcpherson Simon, Kaul Pankaj, Puppala Sapna

机构信息

Leeds Teaching Hospital, Leeds, United Kingdom.

出版信息

Vasc Endovascular Surg. 2014 Apr;48(3):251-5. doi: 10.1177/1538574413513847. Epub 2013 Dec 12.

Abstract

Ascending aorta pseudoaneurysm (AAPA) is an uncommon complication following replacement of the ascending aorta with a prosthetic graft, carry a high risk of rupture, and warrant urgent intervention. The open surgical procedure "gold standard" of care is not always favorable, as the reoperations are technically more difficult or patient's general condition doesn't allow proceeding. Case discussed is an 80-year-old male patient who presented with worsening cough and hemoptysis. He underwent ascending aorta replacement 10 years ago. Computed tomography (CT) scan revealed a contrast-filled mediastinal mass communicating with the ascending aorta and extended into the right lung. Due to the patient's advanced age, friability and clinical condition, combined with the position of the AAPA behind the sternum, surgery was deemed to be high risk. However, favorable anatomical conditions provided a safe landing zone for an endovascular stent. The patient underwent closed procedure. Postprocedure CT showed complete obliteration of the AAPA.

摘要

升主动脉假性动脉瘤(AAPA)是人工血管置换升主动脉后一种罕见的并发症,具有较高的破裂风险,需要紧急干预。护理的开放手术“金标准”并不总是有利的,因为再次手术在技术上更困难,或者患者的一般状况不允许进行。所讨论的病例是一名80岁男性患者,出现咳嗽和咯血加重。他10年前接受了升主动脉置换术。计算机断层扫描(CT)显示一个充满造影剂的纵隔肿块与升主动脉相通并延伸至右肺。由于患者年龄较大、组织脆弱和临床状况,再加上AAPA位于胸骨后,手术被认为风险很高。然而,有利的解剖条件为血管内支架提供了一个安全的着陆区。患者接受了闭合手术。术后CT显示AAPA完全闭塞。

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