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Bentall手术后发生右侧心力衰竭的罕见病例。

A rare case of right-sided heart failure after bentall procedure.

作者信息

Ghavidel Alireza Alizadeh, Shojaeifard Maryam, Mirmesadagh Yalda

机构信息

Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Center, Tehran, Iran.

出版信息

J Tehran Heart Cent. 2014;9(4):183-5. Epub 2014 Jul 6.

Abstract

Pseudoaneurysms of the ascending aorta, which are rare and life-threatening complications in cardiovascular surgeries, can be caused by the Bentall procedure. We describe a 44-year-old woman, who had a medical history of acute aortic dissection (Type A) and the Bentall procedure and was admitted because of exertional dyspnea, edema of the lower extremities, ascites, and holosystolic murmur in the left lower sternal border. Preoperative echocardiography revealed a pseudoaneurysm of the ascending aorta and fistulization of the pseudoaneurysm to the right atrium. Multi-slice computed tomographic scan also showed a large pseudoaneurysm of the ascending aorta around the tube graft. The patient underwent surgery, during which the pseudoaneurysm was resected, the ostium of the right coronary artery was reimplanted, and the orifice of the right atrial fistula was sutured. Intraoperative transesophageal echocardiography revealed the perfect result of the surgery. The patient was discharged uneventfully.

摘要

升主动脉假性动脉瘤是心血管手术中罕见且危及生命的并发症,可由Bentall手术引起。我们描述了一名44岁女性,她有急性A型主动脉夹层病史并接受了Bentall手术,因劳力性呼吸困难、下肢水肿、腹水以及胸骨左缘下部全收缩期杂音入院。术前超声心动图显示升主动脉假性动脉瘤以及假性动脉瘤与右心房的瘘管形成。多层计算机断层扫描也显示人工血管周围有一个巨大的升主动脉假性动脉瘤。患者接受了手术,术中切除了假性动脉瘤,重新植入右冠状动脉开口,并缝合了右心房瘘口。术中经食管超声心动图显示手术效果完美。患者顺利出院。

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