Teratani Hiromitsu, Matsumura Hitoshi, Sukehiro Yuta, Hayashida Yoshio, Minematsu Noritoshi, Wada Hideichi
Department of Cardiovascular Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
Division of Cardiovascular Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
J Vasc Surg Cases Innov Tech. 2020 Dec 28;7(1):93-96. doi: 10.1016/j.jvscit.2020.12.007. eCollection 2021 Mar.
Thoracic endovascular aortic repair of the ascending aorta remains challenging. We have reported the case of an 81-year-old woman with ascending aortic injury who underwent a life-saving hybrid repair. The patient had previously undergone extended radical mastectomy and postoperative radiotherapy for breast cancer, which had resulted in a right thoracic wall defect and bone exposure and osteonecrosis of the sternum. Therefore, the ascending aorta was directly compressed by the sternum at the level of the brachiocephalic artery bifurcation, causing persistent bleeding from the thoracic wall. Hybrid zone 0 debranching thoracic endovascular aortic repair with a left subclavian artery inflow was emergently performed and achieved hemostasis.
升主动脉的胸段血管腔内修复术仍然具有挑战性。我们报告了一例81岁升主动脉损伤女性患者，她接受了挽救生命的杂交修复手术。该患者此前因乳腺癌接受了扩大根治性乳房切除术和术后放疗，导致右胸壁缺损、胸骨骨质暴露和骨坏死。因此，在头臂动脉分叉水平，升主动脉直接受到胸骨压迫，导致胸壁持续出血。紧急进行了带左锁骨下动脉流入道的0区杂交去分支胸段血管腔内主动脉修复术，实现了止血。
