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手术修复合并主动脉多发动脉瘤的颈主动脉弓假性缩窄:一例报告

Surgical repair of a pseudocoarctation with cervical aortic arch complicated by multiple aneurysms of the aorta: a case report.

作者信息

Makani Said, Mitchell Julia, Metton Olivier, Di Filippo Sylvie, Henaine Roland, Ninet Jean

机构信息

Department of Cardiovascular and Congenital Surgery, Louis Pradel Hospital, Bron, Lyon, France.

Department of Paediatric and Congenital Cardiology, Louis Pradel Hospital, Bron, Lyon, France.

出版信息

Pan Afr Med J. 2017 Apr 25;26:236. doi: 10.11604/pamj.2017.26.236.11800. eCollection 2017.

Abstract

Aortic pseudocoarctation is a rare congenital anomaly characterized by elongation and deformity of the aortic arch and is known to be associated with aneurysmal formation. Several studies unite to say it leads to a surgical sanction as soon as symptomatic or associated with aneurysms of the aortic arch. Our patient is a 12 years old boy, followed since birth for a little tight pseudocoarctation with a cervical aortic arch and transverse aortic arch hypoplasia. Close clinical and paraclinical monitoring including angioscans, showed the gradual enlargement of the superior mediastinum, in relation with the appearance of three aneurysms of the aortic arch. The intervention, performed by sternotomy, has consisted of the resection of the aneurysmal area and the interposition of a Dacron tube to repair the aortic arch and the reimplantation of the left subclavian artery into the left carotid artery. The postoperative course was uneventful. Management of pseudocoarctation associated with cervical aortic arch and aneurysms remains surgical. Close monitoring of patients with pseudocorctation, seems to be essential to avoid fatal complications such as aneurysmal rupture.

摘要

主动脉假性缩窄是一种罕见的先天性异常,其特征为主动脉弓伸长和畸形,已知与动脉瘤形成有关。多项研究一致表明,一旦出现症状或与主动脉弓动脉瘤相关,就需要进行手术治疗。我们的患者是一名12岁男孩,自出生起就因轻度狭窄的假性缩窄、颈主动脉弓和横主动脉弓发育不全而接受随访。包括血管造影在内的密切临床和辅助检查显示,上纵隔逐渐增大,这与主动脉弓出现三个动脉瘤有关。通过胸骨切开术进行的干预包括切除动脉瘤区域、置入涤纶补片修复主动脉弓以及将左锁骨下动脉重新植入左颈动脉。术后过程顺利。对于与颈主动脉弓和动脉瘤相关的假性缩窄,手术治疗仍然是主要手段。对假性缩窄患者进行密切监测,对于避免诸如动脉瘤破裂等致命并发症似乎至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86bf/5491740/2dabe328ef02/PAMJ-26-236-g001.jpg

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