在巨细胞动脉炎中同时进行节肺根置换和节大动脉根置换
Joshua R Chen1, Bradley Taylor1, Aakash Shah1
1Division of Cardiac Surgery, Department of Surgery, University of Maryland, Baltimore, MD, USA
Multimedia manual of cardiothoracic surgery : MMCTS
|September 1, 2025
概括
巨细胞动脉炎很少同时导致大动脉和肺根动脉瘤. 这一案例突出显示了在患有这种罕见疾病的患者中,
科学领域:
- 心血管外科
- 关节病学
- 血管医学
背景情况:
- 巨细胞动脉炎 (GCA) 是一种全身性血管炎,主要影响中大动脉.
- 大动脉和肺根动脉瘤是GCA的罕见表现.
- 由于GCA,主动脉和肺动脉的同时发生的动脉瘤非常罕见.
研究的目的:
- 报告一个罕见的同时发生的大动脉和肺部根动脉瘤的病例,
- 描述这种复杂的表现的手术管理.
- 强调在患有不明原因的大动脉和肺根扩张的患者中考虑GCA的重要性.
主要方法:
- 一个被诊断患有巨细胞动脉炎的病例.
- 涉及同时进行节动脉根置换 (VSARR) 和节肺根置换 (VSPRR) 的手术.
- 在同一次手术中同时进行三门修复.
主要成果:
- 取得了成功的同时VSARR和VSPRR.
- 三门的修复成功完成.
- 患者很好地忍受了复杂的手术,没有立即报告的并发症.
结论:
- 巨细胞动脉炎可能导致罕见但严重的心血管并发症,包括同时发生的大动脉和肺根动脉瘤.
- 在GCA的特定情况下,对大动脉和肺根的门节约技术是可行的.
- 多学科治疗,包括风湿学和心胸外科手术,对于患者的最佳治疗结果至关重要.
更多相关视频
12:17Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
11.5K
05:31Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
3.0K
相关概念视频
Aortic Regurgitation III: Medical Management
42
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
42
Rheumatic Heart Disease I: Introduction
38
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
38
Mitral Stenosis III: Medical Management
21
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
21
Aneurysm III: Interprofessional Care
24
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
24
Rheumatic Heart Disease III: Medical Management
31
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
31
