Niclauss Lars, Namasivayam Jegaruban, Kirsch Matthias, Prêtre René
Department of Cardiovascular Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
Eur J Cardiothorac Surg. 2020 Apr 1;57(4):801-802. doi: 10.1093/ejcts/ezz236.
Aortic dissections after deceleration traumas are mainly located in the region of the proximal descending thoracic aorta. Less common are brachiocephalic trunk ruptures, which are not automatically amenable to an endovascular treatment. We present a poly-traumatized patient with an intimal tear at the origin of the brachiocephalic tunk with intramural haematoma extension to the ascending aorta. In addition, the left common carotid artery originated from the proximal brachiocephalic trunk, forming a 'bovine arch'. Aortic arch and supra-aortic arteries were successfully replaced. The case demonstrates the importance of an individualized treatment in complex intrathoracic vascular injuries in poly-traumatized patients, including a careful risk assessment.
减速性创伤后主动脉夹层主要位于胸降主动脉近端区域。头臂干破裂较少见，且不一定适合血管内治疗。我们报告一例多发伤患者，其头臂干起始处存在内膜撕裂，并伴有壁内血肿延伸至升主动脉。此外，左颈总动脉起源于近端头臂干，形成“牛型主动脉弓”。成功进行了主动脉弓和主动脉弓上动脉置换。该病例表明，对于多发伤患者复杂的胸内血管损伤，个体化治疗非常重要，包括仔细的风险评估。
