Nomura Yoshikatsu, Kawasaki Ryota, Kawashima Motoharu, Tanaka Hiroshi, Murakami Hirohisa
Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan.
Department of Radiology, Hyogo Brain and Heart Center at Himeji, Himeji, Hyogo, Japan.
Ann Vasc Dis. 2020 Dec 25;13(4):454-456. doi: 10.3400/avd.cr.20-00122.
Anastomotic pseudoaneurysm and patch aneurysm are life-threatening complications following thoracoabdominal and descending thoracic aortic aneurysm (DTAA) repair. The aortic wall tissue is fragile in patients with Marfan syndrome, who are at high risk of anastomotic pseudoaneurysm and patch aneurysms. We experienced a rare case of ruptured pseudoaneurysm of the intercostal patch after DTAA repair in a patient with Marfan syndrome. A hematoma was separated from the pseudoaneurysm caused by adhesion of the left lung after DTAA repair, which made diagnosis difficult. To prevent type II endoleak and achieve thoracic endovascular aortic repair, we treated the patent intercostal arteries by embolization.
吻合口假性动脉瘤和补片动脉瘤是胸腹主动脉瘤和降主动脉瘤（DTAA）修复术后危及生命的并发症。马凡综合征患者的主动脉壁组织脆弱，发生吻合口假性动脉瘤和补片动脉瘤的风险很高。我们遇到了一例罕见的马凡综合征患者在DTAA修复术后肋间补片假性动脉瘤破裂的病例。DTAA修复术后，血肿因左肺粘连与假性动脉瘤分离，这使得诊断困难。为预防II型内漏并实现胸主动脉腔内修复，我们通过栓塞治疗了开放的肋间动脉。
