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胸主动脉腔内修复术后并发主动脉瘘的解剖外升胸-腹旁路术。

Extra-anatomical ascending-thoraco-abdominal bypass for aortic fistula after thoracic endovascular aortic repair.

机构信息

Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth and Memorial Hermann Hospital, Houston, TX, USA.

出版信息

Eur J Cardiothorac Surg. 2019 Dec 1;56(6):1199-1201. doi: 10.1093/ejcts/ezz141.

Abstract

Aortobronchial and aorto-oesophageal fistulae after thoracic endovascular aortic repair (TEVAR) for traumatic aortic injuries are rare but serious. Potentially fatal complications may occur years after the stent graft deployment. Surgical management is challenging. We report on a 33-year-old male with aorto-oesophageal fistula and a 25-year-old male with aortobronchial fistula-both of whom received TEVAR for traumatic aortic injury. Each underwent successful staged open surgical repair with extra-anatomical bypass from the ascending aorta to the thoraco-abdominal aorta, along with arch vessel reconstructions and debridement of infected lesions. They remained alive after 18 months.

摘要

胸主动脉腔内修复术(TEVAR)治疗创伤性主动脉损伤后发生的主-支气管瘘和主-食管瘘较为罕见,但后果严重。支架移植物置入数年后可能会发生致命的并发症。手术治疗极具挑战性。我们报告了 2 例男性患者,年龄分别为 33 岁和 25 岁,他们均因创伤性主动脉损伤接受了 TEVAR 治疗,分别患有主-食管瘘和主-支气管瘘。这 2 例患者均成功地接受了分期开放性手术修复,包括从升主动脉至胸腹主动脉的体外旁路手术,同时进行了弓部血管重建和感染病灶清创术。术后 18 个月,2 例患者均存活。

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