Smith Kayla, Rossi Peter, Rokkas Chris, LoGiudice John, Doren Erin
Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee, Wisc.
Division of Vascular and Endovascular Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisc.
J Vasc Surg Cases Innov Tech. 2019 Jun 25;5(3):255-258. doi: 10.1016/j.jvscit.2019.02.010. eCollection 2019 Sep.
A 67-year-old man presented to the vascular service with a Crawford extent I thoracoabdominal aortic aneurysm. He underwent open thoracoabdominal aortic replacement from just distal to the left subclavian artery to just proximal to the origin of the superior mesenteric artery under deep hypothermic circulatory arrest. His postoperative course was complicated by thoracic wall ischemia, resulting in a life-threatening defect of the chest wall that exposed lung parenchyma and the aortic graft. Successful microvascular soft tissue reconstruction was performed using an anterolateral thigh flap and arteriovenous loop. This is a case report of a large chest wall defect resulting from thoracoabdominal aortic aneurysm repair. This case highlights the feasibility of microvascular reconstruction techniques to repair even the largest defects.
一名67岁男性因克劳福德I型胸腹主动脉瘤就诊于血管外科。他在深低温循环停搏下接受了从左锁骨下动脉远端至肠系膜上动脉起始部近端的开放性胸腹主动脉置换术。他的术后病程因胸壁缺血而复杂化,导致胸壁出现危及生命的缺损,暴露了肺实质和主动脉移植物。使用股前外侧皮瓣和动静脉袢成功进行了微血管软组织重建。这是一例因胸腹主动脉瘤修复导致的大型胸壁缺损的病例报告。该病例突出了微血管重建技术修复甚至是最大缺损的可行性。