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缩窄前主动脉弓动脉瘤合并迷走动脉的一期手术修复

Single-stage surgical repair of a pre-coarctation aortic arch aneurysm and arteria lusoria.

作者信息

Kanj Mouhammad, Mansour Ziad, Farhat Fadi

机构信息

Cardiothoracic Surgery Department, Lebanese Geitaoui University Medical Centre, Beirut, Lebanon.

Cardiovascular Surgery Department, Alain Sisteron Institute, Infirmerie Protestante de Lyon, Caluire-et-Cuire, France.

出版信息

Interdiscip Cardiovasc Thorac Surg. 2024 Dec 25;40(1). doi: 10.1093/icvts/ivae220.

DOI:10.1093/icvts/ivae220
PMID:39786473
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11771764/
Abstract

Managing an adult patient with aortic coarctation and associated anomalies presents a significant surgical challenge. We present a case of an adult male with aortic coarctation, pre-coarctation distal arch 7-cm aneurysm involving the origin of the left subclavian artery, and aberrant (lusoria) right subclavian artery. He was managed with one surgical approach, consisting of right carotid-subclavian bypass, exclusion of the right subclavian artery, proximal descending aortic replacement and reinsertion of left subclavian artery, using partial cardiopulmonary bypass.

摘要

管理患有主动脉缩窄及相关异常的成年患者是一项重大的外科挑战。我们报告一例成年男性病例，该患者患有主动脉缩窄、缩窄前远端弓部7厘米动脉瘤累及左锁骨下动脉起始部，以及迷走（lusoria）右锁骨下动脉。他接受了一种手术方法治疗，包括右颈动脉-锁骨下动脉旁路移植术、右锁骨下动脉旷置、近端降主动脉置换以及左锁骨下动脉再植入，采用部分体外循环。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00e0/11771764/2e9b1d311c6f/ivae220f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00e0/11771764/af82aab2044d/ivae220f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00e0/11771764/2e9b1d311c6f/ivae220f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00e0/11771764/af82aab2044d/ivae220f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00e0/11771764/2e9b1d311c6f/ivae220f2.jpg

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本文引用的文献

1
Prevalence and Complications of Aberrant Subclavian Artery in Patients With Heritable and Nonheritable Arteriopathies.遗传性和非遗传性动脉疾病患者异常锁骨下动脉的患病率和并发症。
J Am Coll Cardiol. 2023 Mar 14;81(10):979-991. doi: 10.1016/j.jacc.2023.01.005.
2
Saccular "Cauliflower" aneurysm of coarctation of aorta: a hybrid management.升主动脉缩窄处囊状“菜花”状动脉瘤的杂交治疗。
Cardiol Young. 2020 Sep;30(9):1360-1362. doi: 10.1017/S1047951120002140. Epub 2020 Aug 3.
3
Ascending aortic dilatation associated with bicuspid aortic valve: pathophysiology, molecular biology, and clinical implications.
与二叶式主动脉瓣相关的升主动脉扩张：病理生理学、分子生物学及临床意义。
Circulation. 2009 Feb 17;119(6):880-90. doi: 10.1161/CIRCULATIONAHA.108.795401.
4
Bicuspid aortic valve and coarctation: two villains part of a diffuse problem.二叶式主动脉瓣与主动脉缩窄：同一弥漫性问题中的两个“元凶”。
Heart. 2003 Sep;89(9):965-6. doi: 10.1136/heart.89.9.965.
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Natural history of coarctation of the aorta.主动脉缩窄的自然病史。
Br Heart J. 1970 Sep;32(5):633-40. doi: 10.1136/hrt.32.5.633.