Topcu Ahmet Can, Ciloglu Ufuk, Bolukcu Ahmet, Dagsali Sabri
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Ann Thorac Surg. 2016 Aug;102(2):e81-2. doi: 10.1016/j.athoracsur.2015.12.016.
Traumatic aortic rupture is rupture of all or part of the aortic wall, mostly resulting from blunt trauma to the chest. The most common site of rupture is the aortic isthmus. Traumatic rupture of the ascending aorta is rare. A 62-year-old man with a family history of ascending aortic aneurysm was referred to our hospital after a motor vehicle accident. He had symptoms of cardiogenic shock. A contrast-enhanced computed tomographic scan revealed rupture of the proximal ascending aorta and an ascending aortic aneurysm with a diameter of 55 mm at the level of the sinuses of Valsalva. Transthoracic echocardiography at the bedside revealed severe aortic valvular insufficiency. We performed a successful Bentall procedure. During postoperative recovery, the patient experienced a cerebrovascular accident. Transesophageal echocardiography did not reveal thrombosis of the mechanical prosthesis. The patient's symptoms resolved in time, and he was discharged from the hospital on postoperative day 47 without any sequelae. He has been symptom free during a 6-month follow-up period. We suggest that individuals who have experienced blunt trauma to the chest and have symptoms of traumatic aortic rupture and a known medical history of ascending aortic aneurysm should be evaluated for a rupture at the ascending aorta and the aortic isthmus.
创伤性主动脉破裂是指主动脉壁全部或部分破裂，主要由胸部钝性创伤引起。最常见的破裂部位是主动脉峡部。升主动脉创伤性破裂很少见。一名有升主动脉瘤家族史的62岁男性在机动车事故后被转诊至我院。他有心源性休克症状。增强计算机断层扫描显示升主动脉近端破裂，在主动脉瓣窦水平有一个直径55mm的升主动脉瘤。床边经胸超声心动图显示严重主动脉瓣关闭不全。我们成功实施了Bentall手术。术后恢复期间，患者发生了脑血管意外。经食管超声心动图未显示机械瓣膜血栓形成。患者症状及时缓解，术后第47天出院，无任何后遗症。在6个月的随访期内，他一直无症状。我们建议，对于胸部遭受钝性创伤、有创伤性主动脉破裂症状且有升主动脉瘤病史的个体，应评估升主动脉和主动脉峡部是否破裂。
