Okiwelu Ngozichukwuka, Finn Chris, Vanden Driesen Rohan, Sanders Lucas, Joshi Pragnesh
Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia
Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia.
Asian Cardiovasc Thorac Ann. 2016 Mar;24(3):266-8. doi: 10.1177/0218492314557870. Epub 2014 Oct 27.
Pulmonary artery involvement has been reported in various degrees of complicated dissection of the ascending aorta. The prognosis remains poor without high-risk surgical intervention, but conservative management can be considered in high-risk cases. We report a case of nonoperative management of an octogenarian who presented with a contained rupture of his proximal ascending aorta, likely from a penetrating atherosclerotic ulcer. It was complicated by extrinsic compression of the pulmonary trunk and transient pulmonary hypertension without features of acute right heart failure. He remained alive at the one-year follow-up.
据报道，升主动脉不同程度的复杂性夹层分离会累及肺动脉。若无高风险手术干预，预后仍然很差，但对于高风险病例可考虑保守治疗。我们报告一例非手术治疗的老年患者，该患者近端升主动脉局限性破裂，可能源于穿透性动脉粥样硬化溃疡。其并发症为肺动脉干外部受压和短暂性肺动脉高压，但无急性右心衰竭表现。在一年的随访中，患者仍然存活。
