Management of Concomitant Large Aortic Aneurysm and Severe Stenosis of Aortic Arc
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- Ren Shiyan
- China-Japan Friendship Hospital, Beijing, China
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- Sun Guang
- China-Japan Friendship Hospital, Beijing, China
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- Yang Yuguang
- China-Japan Friendship Hospital, Beijing, China
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- Liu Peng
- China-Japan Friendship Hospital, Beijing, China
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抄録
Primary large saccular aortic aneurysm with high grade stenosis of aortic arc is rare, and no standard therapy is available. We have encountered one case and successfully treated using a hybrid interventional approach. A 59-year-old woman with a 7-day history of headache, dizziness and chest pain, and a 5-year history of hypertension admitted and was diagnosed with transverse aortic aneurysm with sever aortic stenosis, the huge saccular aneurysm was located behind the transverse aortic arc. During surgery, a bypass with graft from ascending aorta to left external iliac artery was made initially in order to ensure the blood supply to the left leg, afterward, a 40 mm × 160 mm covered stent was implanted to cover the orifice of aneurysm and was used as a supporting anchorage in the descending aorta, a second covered stent (20 mm × 100 mm) was implanted to expand the stenosis of aortic arc. Follow-up at 1.5-year after surgery, the patient has been doing well without any surgical complication. A collateral pathway between internal mammary artery and inferior epigastric artery via the superior epigastric artery was found on3-dimensional reconstruction before surgery. Interruption of the compensatory arterial collateral pathway in the patient with severe stenosis of aortic arc should be prevented if possible in order to ensure the satisfactory perfusion of the lower limbs of the body.In conclusion, a patient with transverse aortic aneurysm accompanied with severe aortic stenosis can be treated by hybrid surgery.
収録刊行物
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- Annals of Thoracic and Cardiovascular Surgery
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Annals of Thoracic and Cardiovascular Surgery 20 (1), 84-87, 2014
Annals of Thoracic and Cardiovascular Surgery 編集委員会