Ishida Shinichi, Takemoto Yoshio, Kimata Ryutaro, Yagami Kei
Department of Cardiac Surgery, Gifu Prefectural Tajimi Hospital, 5-161 Maebata-cho, Tajimi-city, Gifu 507-8522, Japan.
Department of Cardiology, Gifu Prefectural Tajimi Hospital, 5-161 Maebata-cho, Tajimi-city, Gifu 507-8522, Japan.
Oxf Med Case Reports. 2024 Sep 22;2024(9):omae110. doi: 10.1093/omcr/omae110. eCollection 2024 Sep.
Acute aortic dissection type A during cardiac catheterization has been reported as a rare but fatal complication. We present a case of acute aortic dissection type A occurring during catheter manipulation in the ascending aorta during mapping of ventricular premature contraction via the retrograde approach. In the present case, transthoracic echocardiography showed no pericardial effusion and no flap of the aorta, but intracardiac echo clearly showed the flap. Enhanced computed tomography revealed the aortic dissection, which extended from the ascending aorta to the bilateral common iliac artery, and the false lumen was thrombosed completely. Emergent surgery was performed and the postoperative course was uneventful, and he was discharged with no complications. Aortic dissection is a rare complication of cardiac catheterization, and early detection could prevent a fatal outcome. It is important to detect the signs and symptoms as quickly as possible and perform various diagnostic examinations.
心脏导管插入术期间发生的急性A型主动脉夹层已被报道为一种罕见但致命的并发症。我们报告了1例在经逆行途径标测室性早搏时于升主动脉进行导管操作期间发生急性A型主动脉夹层的病例。在本病例中，经胸超声心动图显示无心包积液且无主动脉瓣叶，但心内超声清晰显示了瓣叶。增强计算机断层扫描显示主动脉夹层，其从升主动脉延伸至双侧髂总动脉，且假腔完全血栓形成。急诊手术顺利进行，术后病程平稳，患者出院时无并发症。主动脉夹层是心脏导管插入术的一种罕见并发症，早期发现可预防致命后果。尽快发现体征和症状并进行各种诊断检查很重要。
