Kohler Corinne, Wyss Thomas R, Mertineit Nando, Makaloski Vladimir, Schmidli Juerg
Department of Cardiovascular Surgery, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Division of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
J Vasc Surg Cases Innov Tech. 2020 Nov 5;7(1):180-182. doi: 10.1016/j.jvscit.2020.10.017. eCollection 2021 Mar.
Thoracic endovascular aortic repair (TEVAR) is the standard of care for ruptured thoracic aortic aneurysms. A 92-year-old man had presented in stable condition but with acute severe back pain. Computed tomography revealed a ruptured thoracic aortic aneurysm. TEVAR (Valiant; Medtronic Vascular, Santa Rosa, Calif) into zone 2 with intentional coverage of the left subclavian artery was planned. After release of the stent-graft body, proximal release of the bare springs was impossible. Troubleshooting techniques were applied; but tip capture could not be released. Emergent conversion to open repair was performed. Intraoperative device deployment failure in TEVAR is rare. The findings from the present report have demonstrated the advantages of having in-house cardiac surgery backup available.
胸主动脉腔内修复术（TEVAR）是治疗破裂性胸主动脉瘤的标准治疗方法。一名92岁男性患者就诊时病情稳定，但伴有急性严重背痛。计算机断层扫描显示为破裂性胸主动脉瘤。计划进行TEVAR（Valiant；美敦力血管，加利福尼亚州圣罗莎），将支架移植物置于2区，并有意覆盖左锁骨下动脉。释放支架移植物主体后，无法进行裸弹簧近端释放。应用了故障排除技术，但尖端捕获仍无法解除。遂紧急转为开放修复术。TEVAR术中器械部署失败很少见。本报告的研究结果表明了有心脏外科内部备用支持的优势。
