Suzuki Daiki, Kuroda Yoshinori, Mizumoto Masahiro, Ishizawa Ai, Watanabe Daisuke, Nakai Shingo, Kobayashi Kimihiro, Arai Syusuke, Uchida Tetsuro
Second Department of Surgery, Yamagata University, Yamagata, Japan.
Kyobu Geka. 2022 Apr;75(4):307-311.
Transcatheter aortic valve implantation (TAVI)-related Stanford type B aortic dissection is an extremely rare but potentially fatal complication. Here, we present a case of 82-year-old man who developed acute type B aortic dissection during transfemoral TAVI. During successful TAVI procedure, dissection in the descending aorta was demonstrated by transesophageal echocardiography. Computed tomography( CT) clearly showed Stanford type B aortic dissection and an intimal tear in severely tortuous part of the descending aorta. Cause of aortic dissection was supposed to be related to the guidewire or the device that passed across affected position. The patient showed no complication associated with aortic dissection, such as rupture or malperfusion. Therefore, he was treated conservatively, and follow-up CT confirmed progressive clotting of the false lumen. Although the indication for TAVI has got broaden recently, physicians should be always aware of possible aortic dissection.
经导管主动脉瓣植入术（TAVI）相关的斯坦福B型主动脉夹层是一种极其罕见但可能致命的并发症。在此，我们报告一例82岁男性患者，其在经股动脉TAVI过程中发生了急性B型主动脉夹层。在成功的TAVI手术过程中，经食管超声心动图显示降主动脉夹层。计算机断层扫描（CT）清楚地显示了斯坦福B型主动脉夹层以及降主动脉严重迂曲部位的内膜撕裂。主动脉夹层的原因推测与穿过病变部位的导丝或器械有关。该患者未出现与主动脉夹层相关的并发症，如破裂或灌注不良。因此，对其进行了保守治疗，随访CT证实假腔逐渐形成血栓。尽管TAVI的适应证最近有所拓宽，但医生应始终意识到可能发生主动脉夹层。
