Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine; and Department of Cardiovascular Surgery, Texas Heart Institute; Houston, Texas 77030.
Tex Heart Inst J. 2020 Apr 1;47(2):149-151. doi: 10.14503/THIJ-17-6423.
Successful surgical repair of aortic coarctation during childhood may have major late complications such as pseudoaneurysm formation. If left untreated, pseudoaneuryms put patients at risk for morbidity and death; if treated surgically, they are associated with complications. Endovascular aortic repair, an established safe alternative to open surgical repair, is associated with encouraging outcomes and fewer complications, and it is especially feasible for patients who have undergone multiple aortic surgeries. We report the case of a 41-year-old man who underwent endovascular repair of a pseudoaneurysm after previous surgical corrections of an aortic coarctation at 6 and 14 years of age. The pseudoaneurysm, involving the distal portion of an ascending-to-descending aortic 20-mm Dacron bypass graft, was successfully excluded with a thoracic stent-graft and sealed off with vascular plugs to prevent both blood flow into the pseudoaneurysm and type II endoleak.
儿童时期成功的主动脉缩窄手术修复可能会导致晚期严重并发症，如假性动脉瘤形成。如果不治疗，假性动脉瘤会使患者面临发病和死亡的风险；如果进行手术治疗，又会伴随相关并发症。血管内主动脉修复术是一种成熟的、安全的开放手术修复替代方法，它与令人鼓舞的治疗效果和较少的并发症相关，尤其适用于已经接受过多次主动脉手术的患者。我们报告了一例 41 岁男性的病例，该患者曾分别于 6 岁和 14 岁时接受过主动脉缩窄手术矫正，此次因假性动脉瘤而行血管内修复术。假性动脉瘤累及升主动脉至降主动脉 20 毫米涤纶旁路移植的远端部分，通过胸主动脉支架移植物成功排除，并使用血管塞封闭，以防止血流进入假性动脉瘤和 II 型内漏。
