Aoyagi S, Akashi H, Tayama K, Fujino T
Second Department of Surgery, Kurume University School of Medicine, Japan.
Eur J Cardiothorac Surg. 1997 Jul;12(1):138-40. doi: 10.1016/s1010-7940(97)00116-4.
A 74-year-old woman presented with severe dyspnea without dysphagia. Computed tomographic scans and Digital subtraction angiography revealed the left aortic arch with an aberrant right subclavian artery arising from the Kommerell's diverticulum and tracheal compression. The aortic arch and the Kommerell's diverticulum were aneurysmal and were responsible for this compression. Surgical relief was accomplished by replacement of the aortic arch and reconstruction of the four brachiocephalic vessels with vascular prostheses through a median sternotomy incision extending into the right supraclavicular region.
一名74岁女性因严重呼吸困难就诊,无吞咽困难。计算机断层扫描和数字减影血管造影显示为左位主动脉弓,右锁骨下动脉异常起源于Kommerell憩室并压迫气管。主动脉弓和Kommerell憩室呈动脉瘤样改变,是造成这种压迫的原因。通过正中胸骨切开并延伸至右锁骨上区域的切口,用血管假体置换主动脉弓并重建四条头臂血管,实现了手术减压。