Pólos Miklós, Szabolcs Zoltán, Apor Astrid, Edes István, Paulovich Erzsébet, Merkely Béla
Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122.
Semmelweis Egyetem, Általános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Klinika Budapest.
Orv Hetil. 2014 Nov 2;155(44):1763-7. doi: 10.1556/OH.2014.30028.
Successful treatment of type A acute aortic dissection depends on the promptness of diagnostic evaluation and therapy. Fast diagnosis can be challenged by numerous complications such as myocardial ischemia, acute aortic insufficiency, and disturbances in organ perfusion and pericardial tamponade. The authors report the case history of a 72-year-old woman, who was admitted after resuscitation with ST segment elevation. Echocardiography revealed acute type A aortic dissection with signs of pericardial tamponade. An emergency operation consisting of the resection of the ascending aorta and the reconstruction of the aortic root was performed, which took six hours from admission until the end of the operation. Follow-up examinations demonstrated good left ventricular function and competent aortic valve. The authors propose that with the development of diagnostic and therapeutic options, faster and less invasive interventions will be introduced in near future for the treatment of acute aortic dissection, which may reduce the morbidity and mortality rates of this lethal illness.
A型急性主动脉夹层的成功治疗取决于诊断评估和治疗的及时性。快速诊断可能会受到多种并发症的挑战,如心肌缺血、急性主动脉瓣关闭不全、器官灌注紊乱和心包填塞。作者报告了一名72岁女性的病例史,该患者在复苏后因ST段抬高入院。超声心动图显示为A型急性主动脉夹层并伴有心包填塞迹象。进行了紧急手术,包括升主动脉切除和主动脉根部重建,从入院到手术结束历时6小时。随访检查显示左心室功能良好,主动脉瓣功能正常。作者提出,随着诊断和治疗方法的发展,在不久的将来将引入更快、侵入性更小的干预措施来治疗急性主动脉夹层,这可能会降低这种致命疾病的发病率和死亡率。