Tokuda Yuhei, Saiki Munehiro, Inoue Tomoya, Kinugasa Yusuke, Tamura Kentaro, Tateishi Atsushi, Oshima Yu, Hisamochi Kunikazu, Yunoki Keiji
Department of Cardiovascular Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Hiroshima, City, Japan.
Ann Vasc Dis. 2024 Sep 25;17(3):309-312. doi: 10.3400/avd.cr.24-00033. Epub 2024 Jun 29.
Thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysms (TAAs) is an alternative treatment option for high-risk patients. While conventionally performed via a transfemoral approach, it is sometimes difficult due to poor access routes. We report the case of a 90-year-old man who was incidentally diagnosed with a descending TAA while undergoing computed tomography for esophageal cancer. The patient had undergone Y-graft replacement twice. His Y-graft leg was highly angulated; therefore, a transfemoral approach was considered difficult. Consequently, transapical TEVAR was performed. The postoperative course was uneventful. Transapical TEVAR can be a useful treatment option for TAAs with poor access routes in super-old patients.
胸主动脉瘤（TAA）的胸段血管腔内主动脉修复术（TEVAR）是高危患者的一种替代治疗选择。虽然传统上是通过经股动脉途径进行，但由于入路不佳，有时会很困难。我们报告一例90岁男性患者，在因食管癌接受计算机断层扫描时偶然被诊断为降主动脉瘤。该患者曾两次接受Y型人工血管置换术。他的Y型人工血管腿高度成角；因此，经股动脉途径被认为困难。因此，进行了经心尖TEVAR。术后过程顺利。经心尖TEVAR对于超老年患者中入路不佳的TAA可能是一种有用的治疗选择。
