Mehrpooya Maryam, Eskandari Ramin, Salehi Mehrdad, Shajirat Zeinab, Golabchi Allahyar, Satarzadeh Roya, Zand-Parsa Amir Farhang
Assistant Professor, Department of Cardiology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Assistant Professor, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
ARYA Atheroscler. 2014 Jul;10(4):230-2.
Interrupted aortic arch (IAA) is defined by a lack of the luminal continuity between the ascending and descending thoracic aorta. It is a rare, severe congenital heart defect which without surgery is associated with high mortality in the neonatal period. The aims of this study were to present a case with IAA who was alive until the age of 59 years without any surgical intervention and to review the literatures that have presented IAA cases.
The patient was admitted with respiratory distress and pulmonary edema. Echocardiography showed the sever stenosis in aortic valve and sever left ventricular dysfunction. Cardiac catheterization and angiography confirmed interrupted aorta (type A). The descending thoracic aorta was supplied by extensive collateral vessels from the vertebrobasilar system down to the posterior chest wall and the spine. Surgical correction including coronary artery bypass graft and aortic valve replacement and repair of interruption of the aorta was performed. Three weeks later the patient was died due to uncontrollable gastrointestinal bleeding and hospital acquired pneumonia. We described diagnosis and management of our case.
This case was very interesting for us, because the patient had not been diagnosed until the recent presentation. Similar cases with this diagnosis do not reach adulthood, but our patient was alive up to 59 years of age.
主动脉弓中断(IAA)的定义是升主动脉和降主动脉之间缺乏管腔连续性。它是一种罕见的严重先天性心脏缺陷,若不进行手术,新生儿期死亡率很高。本研究的目的是报告一例活到59岁且未接受任何手术干预的IAA病例,并回顾已报道的IAA病例的文献。
患者因呼吸窘迫和肺水肿入院。超声心动图显示主动脉瓣严重狭窄和严重左心室功能障碍。心导管检查和血管造影证实为主动脉弓中断(A型)。降主动脉由从椎基底系统向下至后胸壁和脊柱的广泛侧支血管供血。进行了包括冠状动脉搭桥术、主动脉瓣置换术和主动脉弓中断修复在内的手术矫正。三周后,患者因无法控制的胃肠道出血和医院获得性肺炎死亡。我们描述了该病例的诊断和治疗。
该病例对我们来说非常有趣,因为该患者直到近期就诊才被诊断出来。类似诊断的病例通常活不到成年期,但我们的患者活到了59岁。