Mori Hisaya, Takagi Hisato
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
Kyobu Geka. 2024 Dec;77(13):1111-1115.
A 61-year-old female underwent ascending aortic replacement (resecting the primary entry in the ascending aorta) for Stanford type A acute aortic dissection 1 year and 8 months before. Her postoperative course was uneventful, and the patient was discharged on 17 days later. Follow-up recent computed tomography (CT) scans, however, revealed dissecting aortic aneurysm of the distal aortic arch due to a new entry at the distal anastomosis of the ascending replacement. Thoracic endovascular aor-tic repair( placing a short stent graft, 52-mm Valiant Navion, into the ascending aorta) was successfully performed to occlude the new entry. Post-procedural CT scans indicated retrograde flow into the false lumen of the aortic arch via a re-entry of the left subclavian artery, and endovascular repair to exclude the re-entry is now planned.
一名61岁女性在1年零8个月前因斯坦福A型急性主动脉夹层接受了升主动脉置换术（切除升主动脉的原发破口）。她的术后过程平稳，患者于17天后出院。然而，近期的随访计算机断层扫描（CT）显示，由于升主动脉置换远端吻合口出现新破口，导致主动脉弓远端发生主动脉夹层动脉瘤。成功实施了胸段血管腔内主动脉修复术（在升主动脉内植入一个短的支架移植物，52毫米的Valiant Navion）以封闭新破口。术后CT扫描显示通过左锁骨下动脉的再破口有逆行血流进入主动脉弓假腔，目前计划进行血管腔内修复以封堵该再破口。
