Morishita Hiroyuki, Ezure Masahiko, Hasegawa Yutaka, Yamada Yasuyuki, Hoshino Joji, Okada Shuichi, Kanazawa Yuta, Kaga Toru
Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
Kyobu Geka. 2021 Nov;74(12):1028-1031.
A 73-year-old woman presented with severe dyspnea. Type A acute aortic dissection with cardiac tamponade was suspected by plain computed tomography (CT). She was referred to our hospital with cardiogenic shock. In our hospital, contrast-enhanced CT revealed a ruptured aortic arch aneurysm and cardiac tamponade, which is a rare and potentially fatal clinical crisis. The left pulmonary artery was compressed by a hematoma, and there was no aortic dissection. Emergent aortic arch replacement under moderate hypothermia with selective cerebral perfusion was successfully performed. A saccular aneurysm at the lesser curvature of the aortic arch ruptured into the pericardial cavity. Her postoperative course was uneventful, and she was discharged home on the 39th postoperative day.
一名73岁女性因严重呼吸困难就诊。普通计算机断层扫描（CT）怀疑为A型急性主动脉夹层伴心脏压塞。她因心源性休克被转诊至我院。在我院，增强CT显示主动脉弓动脉瘤破裂并伴有心脏压塞，这是一种罕见且可能致命的临床危象。左肺动脉被血肿压迫，未发现主动脉夹层。在中度低温下采用选择性脑灌注成功进行了急诊主动脉弓置换术。主动脉弓小弯处的囊状动脉瘤破裂进入心包腔。她术后恢复顺利，术后第39天出院回家。
