Cotroneo Attilio, Martinelli Gian Luca, Barillà David, Diena Marco
Cardiac Surgery Department, Clinica San Gaudenzio-Gruppo Policlinico of Monza, Novara, Italy.
Vascular Surgery Department, Policlinico Universitario G. Martino of Messina, Messina, Italy.
Ann Vasc Surg. 2019 Nov;61:467.e7-467.e9. doi: 10.1016/j.avsg.2019.04.041. Epub 2019 Jul 31.
We report a case of a 57-year-old female with dextrocardia and a solitary kidney. A patch aortoplasty for isthmic aortic coarctation repair was performed 40 years before when she was admitted to our department for dyspnea. Computed tomography scan showed a giant and saccular 10-cm diameter patch false aneurysm. The ascending aortic diameter was 34 mm and the echocardiography confirmed a severe aortic regurgitation of a bicuspid aortic valve. We decided to perform a 2-step approach: biologic aortic valve and ascending aorta replacement with total debranching of the epiaortic vessels and thoracic endovascular aneurysm repair for complete false aneurysm exclusion.
我们报告一例57岁患有右位心和单肾的女性病例。40年前，她因呼吸困难入住我院时，接受了峡部主动脉缩窄修复的补片主动脉成形术。计算机断层扫描显示一个巨大的囊状补片假性动脉瘤，直径为10厘米。升主动脉直径为34毫米，超声心动图证实为二叶式主动脉瓣重度主动脉反流。我们决定采用两步法：生物主动脉瓣置换和升主动脉置换，同时对主动脉旁血管进行完全去分支，并进行胸段血管内动脉瘤修复以完全排除假性动脉瘤。
