Bansal Prerna B, Chaliki Hari P, Kolla Kantha R, Click Roger L, Pochettino Alberto
Tex Heart Inst J. 2020 Feb 1;47(1):38-40. doi: 10.14503/THIJ-18-6618. eCollection 2020 Feb.
A high-velocity gradient across the left ventricular outflow tract is most often caused by aortic valve stenosis. We describe the unusual case of a high-velocity gradient caused by a kinked ascending aortic graft in a 69-year-old man who had Marfan syndrome. The patient had a history of ascending aortic aneurysm and had previously undergone replacement of the aortic root and ascending aorta with use of a bioprosthetic valved graft. The kinking was caused by dilation of the native aortic arch. The patient underwent successful hemi-arch replacement and repair of the kinked graft. Late complications and reoperation after proximal aortic surgery in patients with Marfan syndrome are rare, and a high-velocity left ventricular outflow tract gradient caused by the kinking of the aorta is unusual.
左心室流出道的高速梯度最常见的原因是主动脉瓣狭窄。我们描述了一名69岁患有马凡综合征的男性患者，其高速梯度是由升主动脉移植物扭结引起的罕见病例。该患者有升主动脉瘤病史，此前已使用带生物瓣膜的移植物进行主动脉根部和升主动脉置换。扭结是由天然主动脉弓扩张引起的。患者成功接受了半弓置换和扭结移植物修复。马凡综合征患者近端主动脉手术后的晚期并发症和再次手术很少见，由主动脉扭结引起的左心室流出道高速梯度也不常见。
