Moriyama Y, Shiota K, Hisatomi K, Watanabe S, Saigenji H, Shimokawa S, Toyohira H, Taira A
Second Department of Surgery, Kagoshima University, Faculty of Medicine, Kagoshima City, Japan.
Angiology. 1997 Sep;48(9):839-41. doi: 10.1177/000331979704800912.
A seventy-three-year-old woman had symptoms of aortic dissection. Initial computed tomographic (CT) scan and angiography showed an extensive intramural hematoma (IMH) of the aortic segment from the ascending aorta to the bulk of the descending aorta without intimal tear or false lumen. Two weeks later the patient's symptoms recurred. A repeat CT demonstrated a classic type A aortic dissection with a false lumen and an intimal defect. The patient underwent a successful hemiarch repair with use of selective cerebral perfusion under profound hypothermic circulatory arrest. This case suggests extensive IMH as an important underlying pathology of the aortic dissection.
一名73岁女性出现主动脉夹层症状。初始计算机断层扫描（CT）和血管造影显示，从升主动脉至大部分降主动脉的主动脉段存在广泛的壁内血肿（IMH），无内膜撕裂或假腔。两周后患者症状复发。复查CT显示为典型的A型主动脉夹层，伴有假腔和内膜缺损。患者在深度低温循环停搏下采用选择性脑灌注，成功进行了半弓修复。该病例提示广泛的IMH是主动脉夹层的重要潜在病理改变。
