Hull University Teaching Hospitals NHS Trust, Hull, UK.
Cardiology, Hull University Teaching Hospitals NHS Trust, Hull, UK
BMJ Case Rep. 2024 Sep 20;17(9):e261556. doi: 10.1136/bcr-2024-261556.
A male patient in his 50s presented to the emergency department with a three-day history of shortness of breath, New York Heart Association class IV, and oxygen desaturation. His physical examination revealed a large volume radial pulse with bibasal crepitation in the lungs and a soft diastolic murmur in the aortic area on auscultation of his heart. He was managed on the line of decompensated heart failure. Transthoracic echocardiography showed a dissection flap in the ascending aorta with acute severe aortic regurgitation. A subsequent urgent CT angiography of the whole aorta confirmed a complex type A aortic dissection with an aneurysmal ascending aorta. An emergency type A aortic dissection repair (modified Bentall's procedure) was done. The patient made a good recovery, was discharged successfully 2 weeks after the procedure and was doing well on postoperative follow-up.
一位 50 多岁的男性患者因呼吸困难、纽约心脏协会（NYHA）四级和缺氧性低氧血症到急诊科就诊。体格检查发现桡动脉搏动量大，双肺底部有爆裂音，听诊心脏时有主动脉区柔和的舒张期杂音。他的心力衰竭失代偿正在接受治疗。经胸超声心动图显示升主动脉夹层伴有急性重度主动脉瓣反流。随后对整个主动脉进行紧急 CT 血管造影检查，证实为复杂的 A 型主动脉夹层，伴有升主动脉瘤。紧急进行了 A 型主动脉夹层修复术（改良 Bentall 手术）。患者恢复良好，术后 2 周成功出院，术后随访情况良好。
