Koizumi Shintaro, Yamaguchi Seiichi, Asano Soichi, Fujita Hisanori, Sueta Tomonori, Takeuchi Shigeyasu
1 Department of Cardiovascular Surgery, Chiba Emergency Medical Center, Chiba, Japan.
2 Department of Cardiovascular Surgery, Chiba Cerebral and Cardiovascular Center, Chiba, Japan.
Asian Cardiovasc Thorac Ann. 2017 Nov;25(9):638-641. doi: 10.1177/0218492316654035. Epub 2016 Jun 9.
A 78-year-old man presented with back pain and shock and was transferred to our hospital. Computed tomography showed a ruptured aortic dissection in which the false lumen was thrombosed with an ulcer-like projection, and the mid-esophagus was shifted to the right due to a mediastinal hematoma. He underwent emergency thoracic endovascular aortic repair of the descending thoracic aorta. One week later, esophageal necrosis occurred, and he died of mediastinitis and sepsis on postoperative day 16. Although esophageal necrosis is a rare and fatal complication after thoracic endovascular aortic repair, a management strategy has not yet been established.
一名78岁男性因背痛和休克被转诊至我院。计算机断层扫描显示主动脉夹层破裂,假腔血栓形成并伴有溃疡样突出,由于纵隔血肿,食管中段向右移位。他接受了降主动脉胸段的急诊胸主动脉腔内修复术。一周后发生食管坏死,术后第16天死于纵隔炎和脓毒症。尽管食管坏死是胸主动脉腔内修复术后一种罕见且致命的并发症,但尚未确立治疗策略。