Wu Yuan, Fan Linglin, Liu Fei, Zhuang Hui, Wu Xijie
Department of Cardiac Surgery, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Department of Vascular Surgery, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Front Cardiovasc Med. 2023 Mar 17;10:1134196. doi: 10.3389/fcvm.2023.1134196. eCollection 2023.
Ascending aortic pseudoaneurysm (AAP) is rare but may cause life-threatening complications. Although the placement of a stent graft and the use of occluder devices and vascular plugs to exclude pseudoaneurysm are adopted for some patients, the management of progressive pseudoaneurysms that may rupture at any time remains a challenge that needs to be addressed. In this study, we present the case of a patient with an AAP that was caused by aortic and mitral valve replacement for the giant left ventricle. Aortic pseudoaneurysm was suspected on the basis of a spherical cystic echo (70 × 80 mm) of the ascending aorta; this pseudoaneurysm was detected by an ultrasonic cardiogram, and the diagnosis was confirmed by an aortic computed tomography angiography (CTA) examination. To prevent the unexpected rupture of a progressive pseudoaneurysm, our patient was treated with a 28- mm ASD occluder without any procedural complications. Our patient has a good prognosis, which will inspire clinicians to choose minimally invasive procedures when dealing with such high-risk cases in emergency situations.
升主动脉假性动脉瘤（AAP）较为罕见，但可能导致危及生命的并发症。尽管一些患者采用了支架移植物置入、封堵器装置和血管塞来排除假性动脉瘤，但对随时可能破裂的进行性假性动脉瘤的处理仍然是一个需要解决的挑战。在本研究中，我们报告了一例因巨大左心室行主动脉和二尖瓣置换术后发生AAP的患者。根据升主动脉的球形囊性回声（70×80 mm）怀疑存在主动脉假性动脉瘤；该假性动脉瘤通过超声心动图检测到，并经主动脉计算机断层扫描血管造影（CTA）检查确诊。为防止进行性假性动脉瘤意外破裂，我们的患者接受了28 mm的房间隔缺损封堵器治疗，未出现任何手术并发症。我们的患者预后良好，这将激励临床医生在紧急情况下处理此类高危病例时选择微创手术。
