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病例报告:合并二叶式主动脉瓣和主动脉缩窄的2型主动脉夹层的外科治疗

Case report: Surgical management of type 2 aortic dissection associated with bicuspid aortic valve and aortic coarctation.

作者信息

Arslan Caner, Bozbay Mehmet, Karagöz Seyfullah Halit, Hamid Rauf

机构信息

Cardiovascular Surgery, Medikar Hospital, Merkez, Kocaeli Sağlık ve Teknoloji University, Kocaeli, Turkiye.

Department of Cardiology, Medikar Hospital, Basiskele, Kocaeli, Turkiye.

出版信息

SAGE Open Med Case Rep. 2024 Oct 31;12:2050313X241296300. doi: 10.1177/2050313X241296300. eCollection 2024.

Abstract

This case report describes an exceptional case of aortic aneurysm co-occurring with type II dissection, bicuspid aortic valve, and severe aortic valve regurgitation in a patient with aortic coarctation. A 39-year-old man without any medical history was admitted to the hospital with chest pain. Physical examination revealed a holosystolic murmur and a noticeable blood pressure difference between the upper and lower extremities. Imaging studies unveiled the presence of aortic dissection, aortic coarctation, and a bicuspid aortic valve. The patient underwent an urgent single-stage surgical intervention performed via a median sternotomy approach: the procedure involved patch angioplasty, a mechanical prosthetic valve, and a Dacron tube graft. The patient's follow-up assessments indicated successful outcomes. This case report highlights the complexity of managing concurrent pathologies, suggests a unique surgical approach, and underscores the importance of tailored interventions in rare presentations of cardiovascular diseases.

摘要

本病例报告描述了一例主动脉缩窄患者同时发生主动脉瘤合并II型夹层、二叶式主动脉瓣和严重主动脉瓣反流的特殊病例。一名无任何病史的39岁男性因胸痛入院。体格检查发现全收缩期杂音,上下肢血压存在明显差异。影像学检查显示存在主动脉夹层、主动脉缩窄和二叶式主动脉瓣。患者通过正中胸骨切开术进行了紧急一期手术干预:该手术包括补片血管成形术、机械人工瓣膜和涤纶血管移植。患者的随访评估显示结果成功。本病例报告强调了处理并发疾病的复杂性,提出了一种独特的手术方法,并强调了针对罕见心血管疾病表现进行个性化干预的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fa9/11528801/57ee06857361/10.1177_2050313X241296300-fig1.jpg

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