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严重扭曲的升主动脉人工血管导致血栓栓塞。

Severely Kinked Ascending Aorta Prosthetic Graft Causing Thromboembolism.

作者信息

Hasami Nesar A, Geuzebroek Guillaume S C, Smith Tim, Heijmen Robin H

机构信息

Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.

Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.

出版信息

JACC Case Rep. 2025 Jul 9;30(18):103933. doi: 10.1016/j.jaccas.2025.103933.

Abstract

Thromboembolic events following aortic surgery are rare but can have disastrous consequences for the patient. This case report presents a late thromboembolic neurologic event due to a severely kinked ascending aorta prosthetic graft. A 43-year-old male with vascular Ehlers-Danlos syndrome presents with a cerebellar stroke 5 years after a type A aortic dissection repair. Imaging revealed a thrombus in the distal ascending aorta and left common carotid artery that was suspected to have migrated from a severe kink in the ascending aorta prosthesis. Thrombolysis successfully dissolved the thrombus, but during a subsequent redo surgery for post dissection dilatation, new clots were observed at the kinked prosthesis. This case highlights the risks associated with prosthetic kinking, its implications for thrombus formation, and the necessity of vigilant surveillance and possible (medical) intervention to prevent severe thromboembolic events.

摘要

主动脉手术后的血栓栓塞事件虽罕见,但可能给患者带来灾难性后果。本病例报告呈现了一例因升主动脉人工血管严重扭曲导致的迟发性血栓栓塞性神经事件。一名患有血管性埃勒斯-当洛综合征的43岁男性,在A型主动脉夹层修复术后5年出现小脑梗死。影像学检查发现升主动脉远端和左颈总动脉有血栓,怀疑是从升主动脉人工血管的严重扭曲处迁移而来。溶栓成功溶解了血栓,但在随后针对夹层后扩张进行的再次手术中,在扭曲的人工血管处观察到了新的血栓形成。本病例突出了人工血管扭曲相关的风险、其对血栓形成的影响,以及为预防严重血栓栓塞事件进行密切监测和可能(药物)干预的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc8c/12441394/cc377f050999/ga1.jpg

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