直接修复伴有左主干严重灌注不良的局限性主动脉夹层。
Direct Repair of Localized Aortic Dissection with Critical Malperfusion of the Left Main Trunk.
作者信息
Fujiyoshi Toshiki, Koizumi Nobusato, Nishibe Toshiya, Sugiyama Kayo, Ogino Hitoshi
机构信息
Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
出版信息
Ann Thorac Cardiovasc Surg. 2018 Dec 20;24(6):320-323. doi: 10.5761/atcs.cr.17-00140. Epub 2018 Jan 30.
BACKGROUND
Localized aortic dissection on the left coronary cusp with critical malperfusion of the left main trunk (LMT) is rare and carries a high risk of death.
CASE PRESENTATION
We report a case of a 48-year-old patient who developed localized aortic dissection of the left coronary cusp complicated by critical malperfusion of the LMT of the coronary artery. After percutaneous coronary intervention (PCI) for the LMT, a Koster-Collins-like direct repair of the localized aortic dissection was carried out by closure of the false channel using BioGlue (CyroLife, Inc., Kennesaw, GA, USA) with the reinforcement of double Teflon felt strips.
CONCLUSION
The aortic repair using a modified Koster-Collins technique was successful.
背景
左冠状动脉瓣叶局限性主动脉夹层伴左主干严重灌注不良较为罕见，且死亡风险高。
病例介绍
我们报告一例48岁患者，发生左冠状动脉瓣叶局限性主动脉夹层，并发冠状动脉左主干严重灌注不良。在对左主干进行经皮冠状动脉介入治疗（PCI）后，采用类似Koster-Collins的直接修复方法，使用BioGlue（美国佐治亚州肯尼索市CyroLife公司）封闭假腔，并加用双层特氟龙毡条进行加固，对局限性主动脉夹层进行修复。
结论
采用改良Koster-Collins技术进行主动脉修复取得成功。
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