Daniele Edward, Coleman Alan, Hirsch Ben, McGill Thomas, Fitzwater John
Department of Pediatric Surgery, Department of Cardiovascular Surgery, Texas Tech University Health Sciences Center, 3601 4th Street MS 8312, Lubbock, TX 79430, United States.
Department of Pediatric Surgery, Department of Cardiovascular Surgery, Texas Tech University Health Sciences Center, 3601 4th Street MS 8312, Lubbock, TX 79430, United States.
Int J Surg Case Rep. 2017;39:253-255. doi: 10.1016/j.ijscr.2017.07.022. Epub 2017 Jul 20.
The most common mechanism of aortic injury involves motor vehicle collisions resulting in aortic disruptions, occurring almost exclusively in the chest. Injury to the abdominal aorta following blunt trauma is nearly twenty times less likely to occur than the thoracic aorta. Because of the low incidence, there are few reports regarding the presentation and repair of these particular injuries, especially in the pediatric population.
We present a case of a 7-year-old boy involved in a high speed motor vehicle accident with an abdominal aorta transection at the aortic bifurcation extending into the left iliac artery. The injury was repaired using bovine pericardium with the adventitia and intima of the vessel approximated over the bovine bridge.
Primary repair of thoracic aortic injury has been thoroughly described in the literature with good outcomes yet, abdominal aortic repair remains ambiguous. Few techniques and materials have been described with even less data surrounding the long-term outcomes.
Bovine pericardium is a strong and stable acellular collagenous material with the potential to accelerate endothelialization and tissue regeneration. This remains an interesting field of research as stenosis and pseudo-coarction data have yet to be determined.
主动脉损伤最常见的机制涉及机动车碰撞导致的主动脉破裂,几乎都发生在胸部。钝性创伤后腹主动脉损伤的发生率比胸主动脉低近二十倍。由于发病率低,关于这些特殊损伤的表现和修复的报道很少,尤其是在儿科人群中。
我们报告一例7岁男孩,他在高速机动车事故中发生腹主动脉在主动脉分叉处横断,并延伸至左髂动脉。使用牛心包进行修复,血管的外膜和内膜在牛心包桥上对合。
胸主动脉损伤的一期修复在文献中已有详尽描述且效果良好,但腹主动脉修复仍不明确。描述的技术和材料很少,关于长期结果的数据更少。
牛心包是一种坚固且稳定的无细胞胶原材料,具有加速内皮化和组织再生的潜力。由于狭窄和假性缩窄的数据尚未确定,这仍是一个有趣的研究领域。