Soorae A S, Cleland J, O'Kane H
Thorax. 1977 Dec;32(6):743-8. doi: 10.1136/thx.32.6.743.
Two cases of delayed non-mycotic false aneurysm arising from ascending aortic cannulation site, presenting one-and-a-hald years and seven years after cardiopulmonary bypass, are described. These two cases represent an incidence of 0.12% of this complication. Repair using profound hypothermia and circulatory arrest with femoral artery and femoral vein cannulation for cardiopulmonary bypass is recommended. The advantages and complications of aortic cannulation are discussed and recommendations to minimise the complications of cannulation are made. The clinical presentation and diagnosis of non-mycotic false aneurysms arising from the aortic cannulation site are described. In addition one delayed and two early cases of non-mycotic cannulation site false aneurysms previously published are analysed. Surgeons should be alert to the possibility of this complication in all patients who have had aortic cannulation for cardiopulmonary bypass even in the distant past. Unexpected symptoms such as constant anterior chest pain, dysphagia, hoarseness, and increasing widening of the superior mediastinum on the chest radiograph warrant prompt investigation.
本文描述了两例因升主动脉插管部位出现的迟发性非霉菌性假性动脉瘤病例,分别在体外循环后一年半和七年出现。这两例病例占该并发症发生率的0.12%。建议采用深低温停循环,并通过股动脉和股静脉插管进行体外循环来修复。讨论了主动脉插管的优点和并发症,并提出了尽量减少插管并发症的建议。描述了主动脉插管部位非霉菌性假性动脉瘤的临床表现和诊断。此外,还分析了之前发表的一例迟发性和两例早期非霉菌性插管部位假性动脉瘤病例。外科医生应对所有曾接受过主动脉插管进行体外循环的患者,即使是在过去很长时间,都要警惕这种并发症的可能性。意外出现的症状,如持续的前胸疼痛、吞咽困难、声音嘶哑以及胸部X线片上纵隔增宽加重等,都需要及时进行检查。