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成人先天性主动脉缩窄合并急性A型主动脉壁内血肿的分期杂交技术治疗:1例报告

Adult congenital aortic coarctation complicated by acute type a aortic intramural hematoma treated with a staged hybrid technique: a case report.

作者信息

Li Haoyou, Wang Min, Li Haoyue, Zhang Wenfeng, Wu Jiantao, Niu Zhaozhuo, Sun Lianjie

机构信息

Department of Cardiovascular Surgery, Qingdao Municipal Hospital, Qingdao, 266000, China.

Department of Medical Laboratory, Qingdao Municipal Hospital, Qingdao, China.

出版信息

J Cardiothorac Surg. 2025 Jan 6;20(1):22. doi: 10.1186/s13019-024-03204-w.

Abstract

BACKGROUND

Coarctation of the aorta (CoA) in adults is rare. usually combined with dilatation of the ascending aorta. Further disease progression complicated by hematoma or dissection of the ascending aorta is even more complicated and dangerous.

CASE PRESENTATION

A 58-year-old male patient with CoA complicated by acute type A aortic intramural hematoma (IMH), who was treated with a two-stage hybrid approach involving an urgent Bentall repair procedure and subsequent endovascular stenting. A 4-year follow-up showed a good prognosis for the patient.

CONCLUSION

For patients with aortic coarctation combined with ascending aortic dissection/IMH, life-threatening proximal aortic lesions may be treated first. Secondary stent implantation can then be performed after stabilization to treat the congenital aortic coarctation.

摘要

背景

成人主动脉缩窄(CoA)较为罕见,通常合并升主动脉扩张。升主动脉进一步病变进展并发血肿或夹层则更为复杂且危险。

病例介绍

一名58岁男性患者,患有CoA并伴有急性A型主动脉壁内血肿(IMH),采用两阶段杂交手术治疗,包括紧急Bentall修复手术及随后的血管内支架置入术。4年随访显示患者预后良好。

结论

对于合并升主动脉夹层/IMH的主动脉缩窄患者,可先治疗危及生命的近端主动脉病变。病情稳定后再行二期支架植入术以治疗先天性主动脉缩窄。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b848/11702230/2b656f0e25c8/13019_2024_3204_Fig2_HTML.jpg

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