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经胸腔内血管主动脉修复术及主动脉瓣置换术成功治疗导管后型主动脉缩窄和主动脉瓣关闭不全的两阶段治疗

Successful Two-Stage Treatment for Coarctation of the Aorta-postductal Type and Aortic Regurgitation with Thoracic Endovascular Aortic Repair and Aortic Valve Replacement.

作者信息

Seguchi Ryuta, Horikawa Takafumi, Kiuchi Ryuta, Sanada Junichiro, Ohtake Hiroshi, Watanabe Go

机构信息

Department of Cardiovascular Surgery, New Heart Watanabe International Institute, Tokyo, Japan.

Department of Vascular Surgery, Ageo Central General Hospital, Saitama, Japan.

出版信息

Ann Vasc Dis. 2020 Dec 25;13(4):414-417. doi: 10.3400/avd.cr.20-00040.

Abstract

We herein report a case of a 20-year-old man with aortic regurgitation (AR), coarctation of the aorta (CoA), and patent ductus arteriosus (PDA). The preoperative ankle-brachial pressure index was 0.56 in bilateral extremities. Enhanced computed tomography revealed CoA-postductal type. We decided to perform a two-stage surgery: thoracic endovascular aortic repair (TEVAR) for CoA and PDA and then open surgery for AR. TEVAR was successfully performed with deployment of the stent graft at a 31-mm diameter subsequent to balloon dilation. At 8 days after TEVAR, the patient underwent aortic valve replacement via median sternotomy and was discharged without a complication.

摘要

我们在此报告一例20岁男性患者,患有主动脉瓣关闭不全(AR)、主动脉缩窄(CoA)和动脉导管未闭(PDA)。术前双侧肢体的踝肱压力指数为0.56。增强计算机断层扫描显示为导管后型CoA。我们决定进行两阶段手术:先对CoA和PDA进行胸主动脉腔内修复术(TEVAR),然后对AR进行开放手术。TEVAR手术成功进行,在球囊扩张后植入了直径为31毫米的覆膜支架。TEVAR术后8天,患者通过正中胸骨切开术进行了主动脉瓣置换,术后无并发症出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bae/7758586/1cea663a9ad1/avd-13-4-cr.20-00040-figure01.jpg

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