Department of Cardiovascular Surgery, Shimonoseki City Hospital, Shimonoseki, Yamaguchi, Japan.
Department of Cardiovascular Surgery, Kyusyu University Hospital, Fukuoka, Fukuoka Prefecture, Japan.
Tex Heart Inst J. 2023 Mar 1;50(2). doi: 10.14503/THIJ-22-7891.
Blunt aortic injury is a serious condition with a high mortality rate. Although rare, blunt aortic injury associated with spinal fracture has also been reported, and appropriate management of aortic disease is key to a good outcome. This report is a case of a 78-year-old man who was found to have a transverse fracture (Chance fracture) in the ninth thoracic vertebra, with a sharp bone fragment compressing the thoracic aorta. Early spinal surgery was needed; however, there was concern about the possibility of bleeding from the aorta and surrounding small arteries associated with the bone fragment during spinal surgery. Therefore, thoracic endovascular aortic repair was performed before spinal surgery. The next day after thoracic endovascular aortic repair, posterior spinal instrumentation was performed, and the postoperative course was uneventful. Because aortic injury associated with vertebral fracture can lead to massive bleeding and spinal cord injury, endovascular repair before spinal surgery is reasonable.
钝性主动脉损伤是一种死亡率很高的严重疾病。虽然罕见，但也有报道称与脊柱骨折相关的钝性主动脉损伤，适当的主动脉疾病管理是良好预后的关键。本报告介绍了一例 78 岁男性，发现第 9 胸椎有横断骨折（Chance 骨折），尖锐的骨碎片压迫胸主动脉。需要早期进行脊柱手术，但担心在脊柱手术过程中与骨碎片相关的主动脉和周围小动脉可能会出血。因此，在脊柱手术前进行了胸主动脉腔内修复术。胸主动脉腔内修复术后第二天，进行了后路脊柱内固定术，术后过程平稳。由于与椎体骨折相关的主动脉损伤可导致大量出血和脊髓损伤，因此在脊柱手术前进行血管内修复是合理的。
