Sabzi Feridoun, Khosravi Donya, Hosseini Maryamosadat, Faraji Reza
Preventive Cardiovascular Research Centre Kermanshah, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Preventive Gynecology Research Center, Tehran, Iran.
Ethiop J Health Sci. 2015 Jul;25(3):289-93. doi: 10.4314/ejhs.v25i3.14.
Ascending aortic dissection (AAD) is a rare and serious complication of aortic valve replacement. Multiple risk factors such as connective tissue disease, aortic wall thinning, aortic diameter, calcification of wall, structural features of aortic wall and associated diseases have been considered as a predisposing factor for the occurrences of AAD. Preoperative recognition of these variables with proper intra intra operative logic judgment may decrease the incidence of this complication.
We herein present a huge ascending aorta with dissecting aneurysm (AAD) with a large intra-operative diameter (15 cm) that has not been recorded in the medical literature so far. He presented with dyspnea, chest pain and amazing symptom of superior vena cava syndrome. The patient underwent open heart surgery with resection of ascending aorta aneurysm with classic Bentall operation. The post-operative period was associated with uneventful course and the patient was discharged with good condition on 12(th) post-operative day.
A six months' follow-up revealed abolishment of chest pain and superior vena cava (SVC) syndrome and good prosthetic composite graft function with no recurrence of pseudo aneurysm or dissection.
升主动脉夹层（AAD）是主动脉瓣置换术罕见且严重的并发症。结缔组织病、主动脉壁变薄、主动脉直径、壁钙化、主动脉壁结构特征及相关疾病等多种危险因素被认为是AAD发生的 predisposing 因素。术前识别这些变量并进行适当的术中逻辑判断可能会降低该并发症的发生率。
我们在此呈现一例巨大升主动脉伴夹层动脉瘤（AAD），术中直径达15厘米，这是迄今为止医学文献中未记载过的。患者表现为呼吸困难、胸痛及惊人的上腔静脉综合征症状。患者接受了心脏直视手术，采用经典Bentall手术切除升主动脉瘤。术后过程平稳，患者于术后第12天状况良好出院。
六个月的随访显示胸痛和上腔静脉（SVC）综合征消失，人工复合移植物功能良好，无假性动脉瘤或夹层复发。
