Sato Hisashi, Yoshikai Masaru, Yoshitake Shuichiro, Kuwano Akito
Department of Cardiovascular Surgery, Shin-Koga Hospital, Kurume, Japan.
Kyobu Geka. 2022 Feb;75(2):118-121.
A 78-year-old female presented to our institution with a dry cough and dyspnea. Chest computed tomography( CT) revealed tracheal stenosis caused by compression from a brachiocephalic artery with a bovine aortic arch. Subsequently, surgery was performed in which the brachiocephalic artery was resected, and a total arch replacement using a four-branched graft was completed. We paid particular attention to the graft branches, making sure to avoid contact with the trachea. Both the patient's cough and dyspnea dissipated after the surgery, and a CT revealed the tracheal stenosis had been completely relieved. The patient has remained in good condition for the past three years since the surgery showing no respiratory symptoms or thoracic aortic disease. Because the bovine aortic arch is a known risk factor for thoracic aortic disease, rather than simply reconstructing the brachiocephalic artery, we chose a more aggressive surgical treatment to prevent any possible future thoracic aortic disease.
一名78岁女性因干咳和呼吸困难前来我院就诊。胸部计算机断层扫描（CT）显示，由于头臂动脉受牛主动脉弓压迫导致气管狭窄。随后进行了手术，切除了头臂动脉，并使用四分支移植物完成了全弓置换。我们特别注意移植物分支，确保避免与气管接触。术后患者的咳嗽和呼吸困难均消失，CT显示气管狭窄已完全缓解。自手术以来，患者在过去三年中一直状况良好，未出现呼吸道症状或胸主动脉疾病。由于牛主动脉弓是胸主动脉疾病的已知危险因素，我们选择了更积极的手术治疗方法，而非简单地重建头臂动脉，以预防未来可能出现的胸主动脉疾病。
