Sako H, Hadama T, Mori Y, Shigemitsu O, Miyamoto S, Uchida Y
Second Department of Surgery, Oita Medical University, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jul;42(7):1113-6.
A 55-year-old male was diagnosed as acute type A aortic dissection caused by retrograde propagation from a tear in the descending aorta. A replacement of the descending aorta was performed with a prosthetic graft (VASCUTEK). Sixteen days after the operation, the patient required an emergency operation due to a rupture in the ascending aorta. Transesophageal echo and contrast enhanced CT indicated the point of entry to be at the proximal anastomotic portion of the prosthetic graft and the prosthetic graft (30 mm in diameter) to be dilated to 45 mm. Intimal tear at anastomotic portion owing to graft dilation was suspected as the main factor causing rupture of the ascending aorta.
一名55岁男性被诊断为急性A型主动脉夹层,由降主动脉撕裂逆行扩展所致。采用人工血管(VASCUTEK)进行了降主动脉置换术。术后16天,患者因升主动脉破裂需要进行急诊手术。经食管超声心动图和增强CT显示破口位于人工血管近端吻合部位,人工血管(直径30mm)已扩张至45mm。怀疑吻合部位因血管扩张导致内膜撕裂是引起升主动脉破裂的主要因素。