Tipaldi Marcello Andrea, Orgera Gianluigi, Krokidis Miltiadis E, Laurino Florindo, Capuano Fabio, Rossi Michele
Department of Radiology, Sant'Andrea University Hospital La Sapienza, Rome, Italy.
Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Interv Med Appl Sci. 2018 Dec;10(4):213-215. doi: 10.1556/1646.10.2018.41.
A rare postoperative complication of aortic root replacement is pseudoaneurysm formation. Surgical repair may be rather challenging particularly in patients who are elder and with significant comorbidities. Endovascular approach may also be technically demanding, given the high blood velocity and the anatomical challenges of the area of the aortic root and the ascending aorta. We would like to describe a case of an 85-year-old patient with history of prosthetic graft aortic root replacement who had been developed a 7-cm pseudoaneurysm with sternotomy diastasis and extension in the subcutaneous tissue, 7 years after the initial operation. Given the comorbidities, open repair was not considered a valid option and successful endovascular repair with the use of a ventricular septal occluder plug followed. One-year follow-up confirmed satisfactory exclusion of the pseudoaneurysm with no migration of the endovascular device and no other complication. This is one of the rare cases on endovascular repair of an ascending aorta postoperative pseudoaneurysm.
主动脉根部置换术后一种罕见的并发症是假性动脉瘤形成。手术修复可能颇具挑战性，尤其是对于老年且伴有严重合并症的患者。鉴于主动脉根部和升主动脉区域的高血流速度以及解剖学上的挑战，血管内介入方法在技术上也可能要求很高。我们想描述一例85岁的患者，该患者有主动脉根部人工血管置换史，在初次手术后7年，出现了一个7厘米的假性动脉瘤，伴有胸骨切开处分离并延伸至皮下组织。鉴于其合并症，开放修复不被认为是一个可行的选择，随后使用室间隔封堵器成功进行了血管内修复。一年的随访证实假性动脉瘤得到了满意的封堵，血管内装置无移位，也无其他并发症。这是升主动脉术后假性动脉瘤血管内修复的罕见病例之一。
