Koizumi Shigeki, Fukunaga Naoto, Kinoshita Makoto, Koyama Tadaaki
Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Ann Vasc Surg. 2017 Aug;43:313.e1-313.e3. doi: 10.1016/j.avsg.2017.01.021. Epub 2017 May 4.
Prosthetic graft interposition is performed in some patients with coarctation of the aorta (CoA), and all procedures for treating CoA are associated with a risk of aneurysm formation at the site of repair. A 53-year-old woman underwent coarctectomy and descending aortic replacement with a 16-mm Dacron graft for CoA when she was 18 years old. Thirty years later, she was referred to our hospital for a false aneurysm at the proximal anastomotic site, and total arch replacement was performed to resect the false aneurysm. One year after the operation, follow-up computed tomography revealed a dissecting aneurysm on the descending aorta, originating from the distal anastomotic site, namely the first 16-mm Dacron graft and the native descending aorta. The length between the branch of the arch graft and the dissecting aneurysm was adequate for endovascular repair, which was successfully performed.
对于一些主动脉缩窄（CoA）患者会进行人工血管移植术，而所有治疗CoA的手术都存在修复部位形成动脉瘤的风险。一名53岁女性在18岁时因CoA接受了缩窄切除术和用16毫米涤纶人工血管置换降主动脉。30年后，她因近端吻合口处出现假性动脉瘤被转诊至我院，遂进行全弓置换以切除假性动脉瘤。术后1年，随访计算机断层扫描显示降主动脉出现夹层动脉瘤，起源于远端吻合口处，即最初的16毫米涤纶人工血管与天然降主动脉的连接处。弓部人工血管分支与夹层动脉瘤之间的长度适合进行血管腔内修复，手术顺利完成。
