Parsa Pouria, Eidt John, Rios Anthony, Gable Dennis, Vasquez Javier
Department of Vascular Surgery, Baylor University Medical Center, Dallas, TX.
Department of Vascular Surgery, Baylor University Medical Center, Dallas, TX.
Ann Vasc Surg. 2018 Jan;46:205.e1-205.e4. doi: 10.1016/j.avsg.2017.04.007. Epub 2017 May 4.
It was once postulated that open surgical repair of coarctation of the aorta during childhood patients was cured. However, long-term follow-up has been significant for late problems such as an aneurysm. The incidence of such aneurysm after open surgical coarctation repair is 11-24%. If such an aneurysm is left untreated, patients are at a high risk of morbidity and mortality. Prior to the endovascular era, patients would require a redo open repair which in itself is a highly morbid operation. Currently, thoracic endovascular aortic repair (TEVAR) has been reported as a feasible and safe alternative to open surgical reprocedures in this context. However, TEVAR might be challenging due to the proximity of the pathology to supraaortic vessels and the ongoing presence of the coarctation. We are reporting a unique case of a 48-year-old male undergoing TEVAR due to aortic aneurysm after previous surgical coarctation treatment and successful closure of the coarctation with a vascular plug device.
曾经有人假定，儿童期患者的主动脉缩窄进行开放手术修复后就治愈了。然而，长期随访发现了诸如动脉瘤等晚期问题。开放手术修复主动脉缩窄后此类动脉瘤的发生率为11%至24%。如果此类动脉瘤不治疗，患者发生发病和死亡的风险很高。在血管内治疗时代之前，患者需要再次进行开放修复，而这本身就是一种高风险手术。目前，有报道称在这种情况下，胸主动脉腔内修复术（TEVAR）是开放手术再治疗的一种可行且安全的替代方法。然而，由于病变靠近主动脉弓上血管以及缩窄持续存在，TEVAR可能具有挑战性。我们报告了一例独特病例，一名48岁男性，因先前手术治疗主动脉缩窄后出现主动脉瘤而接受TEVAR，并使用血管封堵装置成功闭合了缩窄。
