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贝赫切特病患者在接受多次主动脉手术后,发生主动脉窦管交界部假性动脉瘤,行带膜支架腔内修复术治疗。

Bail-out coil embolization for a pseudoaneurysm of aortic sinotubular junction in a patient with Behcet's disease after receiving multiple aortic operations.

机构信息

Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea.

Department of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

J Card Surg. 2022 May;37(5):1410-1412. doi: 10.1111/jocs.16304. Epub 2022 Feb 11.

Abstract

Transcatheter repair of a pseudoaneurysm of the aortic sinotubular junction with coils is quite challenging because it can cause coronary or systemic embolization of coils and aortic rupture. A 71-year-old female patient with Behcet's disease who had received repeated surgical aortic repairs presented with a complicated pseudoaneurysm. It developed not on the native aorta, but on the ascending aortic graft. It was positioned just beside the os of the attached trifurcated vascular graft trunk connecting arch vessels. To avoid reopening the sternum, which would have been fatal, coil embolization was successfully performed. This case suggests that transcatheter coil embolization might provide an alternative treatment option for such patients with a high risk of surgical mortality.

摘要

经导管修复主动脉窦管交界假性动脉瘤具有挑战性,因为这可能导致线圈发生冠状动脉或全身栓塞,并引发主动脉破裂。一位 71 岁的女性白塞病患者,曾多次接受外科主动脉修复手术,现患有复杂的假性动脉瘤。该假性动脉瘤不是在原生主动脉上,而是在升主动脉移植物上。它位于连接弓部血管的分叉血管移植物干附着窦部的旁边。为避免胸骨再次打开(这将是致命的),成功地进行了线圈栓塞。该病例提示,对于外科死亡率高的此类患者,经导管线圈栓塞可能提供一种替代治疗选择。

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