Parato Vito Maurizio, Notaristefani Camilla, Gizzi Germana, D'Agostino Simone
Cardiology Unit of Emergency Department, Madonna del Soccorso Hospital, San Benedetto del Tronto, Marche Region, Italy.
J Cardiovasc Echogr. 2021 Jan-Mar;31(1):45-47. doi: 10.4103/jcecho.jcecho_106_20. Epub 2021 May 21.
We present a case of a 91-year-old man presenting to the emergency department with a tearing back pain. The patient's history included an endovascular abdominal aortic repair because of an aneurysm. The transthoracic echocardiography (TTE) appeared normal; however, when transducer was positioned to the left of the spine for the posterior paraspinal window, a clear intimal flap was demonstrated in the descending aorta lumen. The multiphasic computed tomography of the aorta confirmed the diagnosis of Stanford Type-B aortic dissection. The patient underwent thoracic endovascular aortic repair, consisting of a descending aorta endoluminal graft placement and realizing a full metal jacket thoracic-abdominal aorta. At 3-month follow-up, the outcome appeared excellent. The case points out the usefulness of TTE via nonconventional windows in detecting Type-B aortic dissection.
我们报告一例91岁男性因背部撕裂样疼痛就诊于急诊科。患者既往有因动脉瘤行腹主动脉腔内修复术史。经胸超声心动图（TTE）显示正常；然而，当换能器置于脊柱左侧以获取椎旁后窗时，降主动脉腔内可见清晰的内膜瓣。主动脉多期计算机断层扫描证实为斯坦福B型主动脉夹层。患者接受了胸主动脉腔内修复术，包括降主动脉腔内移植物置入及实现全金属护套胸腹主动脉修复。在3个月的随访中，结果显示良好。该病例指出了通过非常规窗口进行TTE在检测B型主动脉夹层中的作用。
