Ando M, Takamoto S, Okita Y, Morota T, Matsukawa R
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Oct;46(10):949-52. doi: 10.1007/BF03217852.
We surgically treated a 35-year-old male with acute 3-channeled aortic dissection in Marfan syndrome. He had acute type A aortic dissection, and underwent Bentall's type operation, simultaneous graft replacement of the ascending aorta and total aortic arch. Pain recurred 5 years and 9 months after the first operation. CT scan showed two adjacent false lumens in the descending aorta. The morphology of the first and second dissections was Stanford type A + B. The second dissection was acute. In the second false lumen, a re-entry formation was observed in the abdominal aorta. Because severe pain was persistent, we immediately replaced the descending aorta using a femoro-femoral partial cardiopulmonary bypass. The patient was doing well and was discharged. When pain recurs in a Marfan patient with an aortic dissection, a 3-channeled aortic dissection should be suspected, and we recommend emergency surgery.
我们对一名患有马凡综合征并急性三通道主动脉夹层的35岁男性进行了手术治疗。他患有急性A型主动脉夹层，接受了Bentall式手术，同时置换了升主动脉和整个主动脉弓。首次手术后5年9个月疼痛复发。CT扫描显示降主动脉有两个相邻的假腔。第一次和第二次夹层的形态为斯坦福A型+B型。第二次夹层为急性。在第二个假腔内，在腹主动脉观察到一个再入路形成。由于严重疼痛持续存在，我们立即使用股-股部分体外循环置换了降主动脉。患者情况良好并出院。当患有主动脉夹层的马凡患者疼痛复发时，应怀疑三通道主动脉夹层，我们建议进行急诊手术。
