65岁男性完全性主动脉夹层的处理:1例报告

Skandaji M. A., Ibenchekroun M., Cherif A., Jroundi L., Cherti M.
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摘要

背景:主动脉夹层是一种危及生命的疾病,其特征是主动脉壁撕裂分离其层。完全性主动脉夹层包括升主动脉和降主动脉,需要及时诊断和干预。我们提出一个65岁男性完全主动脉夹层的病例报告,并讨论在他的治疗中所面临的挑战和管理策略。病例介绍:一名75岁男性,有高血压病史,因突然发作的严重胸痛和背部疼痛来到急诊科。体格检查显示双臂血压读数不均匀,提示主动脉受累。紧急计算机断层血管造影(CTA)和TTE证实了从主动脉根部到髂动脉的完全性主动脉夹层的诊断。患者立即转至手术室进行手术干预。讨论:完全性主动脉夹层的治疗需要多学科合作,包括心血管外科医生、介入放射科医生和麻醉科医生。在这种情况下,进行了紧急手术以解决危及生命的情况。行主动脉根置换术和升主动脉修复术,然后在降主动脉内放置支架以排除假腔。术后护理包括密切监测潜在的并发症,如肾功能不全、截瘫和心脏缺血。结论:及时诊断和适当的手术治疗是治疗完全性主动脉夹层的关键。医疗保健专业人员之间的协作对于优化患者结果至关重要。需要进一步的研究来评估完全性主动脉夹层患者的长期预后,并确定预防并发症的策略。
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Management of Complete Aortic Dissection in a 65-Year-Old Male: A Case Report
Background: Aortic dissection is a life-threatening condition characterized by a tear in the aortic wall that separates its layers. Complete aortic dissection involves both the ascending and descending aorta, necessitating prompt diagnosis and intervention. We present a case report of a 65-year-old male with a complete aortic dissection and discuss the challenges and management strategies employed in his treatment. Case Presentation: A 75-year-old male with a history of hypertension presented to the emergency department with sudden-onset severe chest and back pain. Physical examination revealed unequal blood pressure readings in both arms, suggesting aortic involvement. Urgent computed tomography angiography (CTA) and TTE confirmed the diagnosis of a complete aortic dissection extending from the aortic root to the iliac arteries. The patient was promptly transferred to the operating room for surgical intervention. Discussion: The management of complete aortic dissection requires a multidisciplinary approach involving cardiovascular surgeons, interventional radiologists, and anesthesiologists. In this case, emergency surgery was performed to address the life-threatening condition. Aortic root replacement and ascending aorta repair were performed, followed by stent graft placement in the descending aorta to exclude the false lumen. Postoperative care involved close monitoring for potential complications such as renal dysfunction, paraplegia, and cardiac ischemia. Conclusion: Prompt diagnosis and appropriate surgical intervention are crucial in the management of complete aortic dissection. Collaboration among healthcare professionals is essential for optimizing patient outcomes. Further studies are warranted to assess long-term outcomes and identify strategies for preventing complications in patients with complete aortic dissection.
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