Reiher L, Sandmann W
Klinik für Gefässchirurgie und Nierentransplantation, Heinrich Heine-Universität, Düsseldorf.
Chirurg. 1998 Jul;69(7):753-8. doi: 10.1007/s001040050486.
Coarctation of the thoracic or abdominal aorta often is associated with reduced perfusion of one or both kidneys, resulting in severe renovascular hypertension, which significantly influences the spontaneous course of these patients. Fourteen of 15 patients who were operated upon between 1983 and 1996 suffered from arterial hypertension. Thirteen patients had ischemia of one or both kidneys resulting from renal artery stenosis or stenosis of the descending or visceral aorta. Because of a hemodynamically significant stenosis the aorta was reconstructed in 11 patients by interposition graft, bypass, or patchplasty. Concerned renal or visceral arteries were reconstructed by bypass/interposition graft, patchplasty, or reimplantation. One patient died, presumably from septic bleeding, 3 weeks post operatively. There was a cure of hypertension in 3 and an improvement in 6 patients. In the individual patient hypertension could be cured more often if the diagnosis of coarctation were established early.
胸主动脉或腹主动脉缩窄常伴有一侧或双侧肾脏灌注减少，导致严重的肾血管性高血压，这对这些患者的自然病程有显著影响。1983年至1996年间接受手术的15例患者中有14例患有动脉高血压。13例患者因肾动脉狭窄或降主动脉或内脏主动脉狭窄而出现一侧或双侧肾脏缺血。由于存在血流动力学上有意义的狭窄，11例患者通过植入移植物、搭桥或补片成形术重建主动脉。相关的肾动脉或内脏动脉通过搭桥/植入移植物、补片成形术或再植术进行重建。1例患者术后3周死亡，可能死于败血症性出血。3例患者高血压治愈，6例患者病情改善。如果缩窄的诊断能早期确立，个体患者高血压更常能治愈。
