马凡氏综合征患者漏斗胸行努氏手术后降主动脉置换术——病例报告
Descending aortic replacement after Nuss for pectus excavatum in a Marfan patient-Case report.
作者信息
Jaroszewski Dawn, Ewais MennatAllah, DeValeria Patrick, Gotway Michael, Craig Miller D
机构信息
Division of Cardiothoracic Surgery, Mayo Clinic Arizona, United States.
Division of Cardiothoracic Surgery, Mayo Clinic Arizona, United States.
出版信息
Int J Surg Case Rep. 2016;21:16-9. doi: 10.1016/j.ijscr.2016.01.035. Epub 2016 Feb 7.
INTRODUCTION
The Nuss procedure for pectus excavatum (PE) repair has been successfully performed in Marfan syndrome (MFS) patients however there is concern for future risk of aortic dilation/rupture and need for emergent access with support bars in place.
CASE PRESENTATION
We present a 45 year-old male with MFS that required descending aortic replacement shortly after modified Nuss repair.
DISCUSSION
The majority of MFS patients have severe PE and repair with the Nuss procedure is not uncommon. The risk for life threatening aortic dilation, dissection, or rupture in such patients is a concern when utilizing this technique. Our work has been reported in line with the CARE criteria.
CONCLUSION
Nuss repair should be considered in MFS patients with technique modifications and careful consideration of future risk of aortic dilation and rupture.
引言
努斯手术用于漏斗胸（PE）修复已在马凡综合征（MFS）患者中成功实施，然而，人们担心未来存在主动脉扩张/破裂的风险，以及在支撑棒就位的情况下需要紧急通路。
病例报告
我们报告一名45岁患有马凡综合征的男性，在改良努斯修复术后不久需要进行降主动脉置换。
讨论
大多数马凡综合征患者患有严重漏斗胸，采用努斯手术进行修复并不罕见。在使用该技术时，此类患者发生危及生命的主动脉扩张、夹层或破裂的风险令人担忧。我们的工作已按照CARE标准进行报告。
结论
对于患有马凡综合征的患者，应考虑进行努斯修复，并对技术进行改进，同时仔细考虑未来主动脉扩张和破裂的风险。
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