Ikeda Masahiro, Hosoda Susumu, Shiozaki Yuji, Shiikawa Akira, Azuma Takashi
Department of Cardiovascular Surgery, Sendai Cardiovascular Center, Sendai, Japan.
Kyobu Geka. 2023 Aug;76(8):642-645.
A 79-years-old frail man with severe combined valvular disease was referred to our hospital. Furthermore, chest computed tomography( CT) showed a saccular aneurysm in the aortic arch. We chose two staged repairs for risk reduction. As a first stage double valve replacement and tricuspid annuloplasty were performed. Three months later, we performed successful branched thoracic endovascular aortic repair( TEVAR) used physician modified Najuta which had hydrogel-reinforced fenestrations to provide a more secure connection with the bridging graft than fenestrations alone. Staged surgery with branched TEVAR used physician modified Najuta is a useful strategy in patients who have complex cardiac disease combined with aortic arch aneurysm.
一名79岁患有严重联合瓣膜病的体弱男子被转诊至我院。此外，胸部计算机断层扫描（CT）显示主动脉弓有一个囊状动脉瘤。为降低风险，我们选择了两阶段修复。第一阶段进行了双瓣膜置换和三尖瓣环成形术。三个月后，我们成功进行了分支胸主动脉腔内修复术（TEVAR），使用了医生改良的Najuta，其具有水凝胶增强的开窗，与单独的开窗相比，能与桥接移植物提供更安全的连接。对于患有复杂心脏病合并主动脉弓动脉瘤的患者，采用医生改良的Najuta进行分期手术联合分支TEVAR是一种有用的策略。
