Gomibuchi Toshihito, Takano Tamaki, Wada Yuko, Terasaki Takamitsu, Seto Tatsuichiro, Fukui Daisuke
Department of Cardiovascular Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan.
J Cardiothorac Surg. 2015 Nov 5;10:152. doi: 10.1186/s13019-015-0356-0.
Pseudoaneurysm of graft-graft anastomosis is an extremely rare but potentially fatal complication after thoracic aorta replacement with a prosthetic graft. We report a case of pseudoaneurysm at the graft-graft anastomosis of a hand-sewn branched graft.
A 65-year-old man underwent total arch replacement with a hand-sewn branched graft for Stanford type A acute aortic dissection 22 years ago. During follow-up, serial CT scans showed a pseudoaneurysm on the branched graft which warranted reintervention. Surgical repair involved direct suture of multiple bleeding points which were found at the sites of the hand-sewn branches anastomosis. The postoperative course was uneventful, and no signs of bleeding were observed by CT after the reoperation.
Long-term follow-up is essential to detect late complications at the site of hand-sewn anastomosis.
人工血管移植-移植吻合口假性动脉瘤是胸主动脉人工血管置换术后一种极其罕见但可能致命的并发症。我们报告一例手工缝合分支人工血管移植-移植吻合口假性动脉瘤的病例。
一名65岁男性22年前因斯坦福A型急性主动脉夹层接受了手工缝合分支人工血管全弓置换术。在随访期间，系列CT扫描显示分支人工血管上有一个假性动脉瘤，需要再次干预。手术修复包括直接缝合在手工缝合分支吻合部位发现的多个出血点。术后过程顺利，再次手术后CT未观察到出血迹象。
长期随访对于发现手工缝合吻合部位的晚期并发症至关重要。
