Fleerakkers Jelle, Sonker Uday, Heijmen Robin H
Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.
Department of Cardiothoracic Surgery, Amsterdam AMC, Amsterdam, The Netherlands.
J Vasc Surg Cases Innov Tech. 2020 Feb 20;6(1):101-103. doi: 10.1016/j.jvscit.2019.12.003. eCollection 2020 Mar.
A patient with a chronic postdissection distal arch aneurysm was treated with total arch replacement and frozen elephant trunk. Following uneventful initial recovery, the frozen elephant trunk appeared to be inadvertently perfusing the false lumen through an already present (in retrospect) intimal tear, resulting in rapid dilation of the false lumen and proximal compression of the graft. Treatment consisted, first, of endovascular redirection of flow toward the distal true lumen and, second, open surgical repair of the remaining type IV aneurysm. This case underlines the importance of scrutinizing preoperative imaging for correct use of the frozen elephant trunk.
一名患有慢性夹层分离后远端主动脉弓动脉瘤的患者接受了全主动脉弓置换术和象鼻支架植入术。在术后初期恢复顺利后，象鼻支架似乎通过一个（事后回顾发现）已存在的内膜撕裂无意中向假腔供血，导致假腔迅速扩张并对移植物近端造成压迫。治疗措施首先是通过血管内介入将血流重新导向远端真腔，其次是对剩余的IV型动脉瘤进行开放手术修复。该病例强调了仔细检查术前影像以正确使用象鼻支架的重要性。
