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复杂的混合修复一个异常的右下关节动脉与快速发展的Komerell's转

Egle Kavaliunaite¹, Bo Juel Kjeldsen¹, Annette Midtgaard²

¹Department of Cardiac, Thoracic, and Vascular Surgery, Odense University Hospital, Odense, Denmark.

EJVES vascular forum

|December 13, 2023

概括

异常的右下关节动脉 (ARSA) 与Komerell的分分管 (KD) 可能是危及生命的. 一个单阶段的混合修复成功治疗了快速增长的KD,显示了这种罕见的大动脉异常的有希望的结果.

科学领域:

心血管外科心血管外科
血管外科血管外科
大动脉疾病大动脉疾病

背景情况:

异常右下关节动脉 (ARSA) 是一种先天性大动脉异常.
科默雷尔分歧管 (KD) 是ARSA的一种罕见并发症,由于潜在的进展和破裂,与高死亡率有关.
关于KD治疗的文献有限,缺乏临床指导方针.

研究的目的:

报告一个快速发展的Kamerell's转管病例.
描述一个复杂的ARSA和KD案例的成功管理.
为增加有关KD治疗策略的有限知识做出贡献.

主要方法:

一名50岁的男性患者因ARSA和KD而出现食障碍.
诊断得到证实,并注意到KD迅速扩大 (2个月内4-7厘米).
患者接受了单阶段的混合动脉修复,包括动脉置换,全动脉断,胸内血管动脉修复 (TEVAR) 支架和下关节塞.

主要成果:

患者经历了手术后的中风,在6个月后完全消失.
手术后的计算机断层扫描证实没有内脏泄漏和突出的上大动脉血管.
单阶段混合手术在技术上是成功的,没有观察到长期并发症.

结论:

快速发展的Kamerell的分流器需要及时的干预.
单阶段混合动脉修复是复杂ARSA和KD的可行和有效的治疗选择.
需要进一步的研究和病例报告,以建立KD的治疗共识.

关键词:

异常的右下关节动脉右下关节动脉大动脉门修复路索里亚动脉 (英语:Arteria lusoria) 是一种动脉.科马雷尔会有不同的分歧.

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