Staubach P, Möllers J, Altmann C, Walterbusch G
Klinik für Innere Medizin-Kardiologie Elisabeth-Krankenhaus, Recklinghausen.
Z Kardiol. 1996 Sep;85(9):668-72.
A 63-year-old man with a history of hypertension and coronary artery bypass grafting (1 year ago) was admitted with acute onset severe chest pain suggesting bypass dysfunction. Biplane cineangiography revealed acute aortic dissection Stanford Type A without involvement of the aortic valve, the coronary arteries or the proximal anastomoses of the two venous bypass grafts, one of which was occluded. Urgent repair of the aorta by a prosthesis and reinsertion of the patent venous graft in the innominate artery by interposition of saphenous vein was performed without complications. Sixteen months later on routine follow-up a pseudoaneurysm of the ascending aorta surrounding the aortic prosthesis was discovered by transesophageal echocardiographic examination. Reoperation was performed with prosthetic replacement of the ascending aorta. The operative course and further follow-up of now 1.5 years were uneventful.
一名63岁男性，有高血压病史且1年前接受过冠状动脉旁路移植术，因急性发作的严重胸痛入院，提示旁路功能障碍。双平面电影血管造影显示为急性A型主动脉夹层，未累及主动脉瓣、冠状动脉或两条静脉旁路移植血管的近端吻合口，其中一条静脉旁路移植血管闭塞。紧急行人工血管主动脉修复术，并通过大隐静脉间置将通畅的静脉移植血管重新植入无名动脉，手术无并发症。16个月后常规随访时，经食管超声心动图检查发现围绕主动脉人工血管的升主动脉假性动脉瘤。再次手术，用人造血管置换升主动脉。目前1.5年的手术过程及进一步随访均顺利。
