[与真性左心室动脉瘤相关的巨大假性动脉瘤]。

Q4 Medicine Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-06-01
Toru Koakutsu, Masanao Nakai, Shinnosuke Goto, Fumio Yamazaki
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引用次数: 0

摘要

一名 66 岁的男子出现了劳力性呼吸困难。患者 53 岁时曾因主动脉弓动脉瘤破裂而接受全弓置换术,60 岁时因心肌梗死接受保守治疗。多项造影检查显示,患者体内有一个巨大的假性动脉瘤,很可能源自真正的心室动脉瘤。假性动脉瘤严重压迫右心室。手术立即进行。患者有心脏手术史,且心包完全致密粘连。因此,我们切开假性动脉瘤,在快速起搏下直接从假性动脉瘤内部缝合破裂口。对于破裂口小而粘连致密的患者,这种方法可能是一种有效的手术替代方案。
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[A Giant Pseudoaneurysm Associated with a True Left Ventricular Aneurysm].

A 66-year-old man developed exertional dyspnea. The patient had undergone total arch replacement for a dissecting aortic arch aneurysm at the age of 53 and conservative treatment for myocardial infarction at the age of 60. Several imaging studies revealed a giant pseudoaneurysm that likely originated from a true ventricular aneurysm. The pseudoaneurysm severely compressed the right ventricle. Surgery was promptly performed. The patient had a history of cardiac surgery and had exclusively dense pericardium adhesion. Therefore, we incised the pseudoaneurysm and sutured the rupture orifice directly from inside the pseudoaneurysm under rapid pacing. This approach may represent an effective surgical alternative in patients with small rupture orifice and dense adhesions.

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