Yasunori Iida, Yoichi Marushita, Yuka Motohashi, Toshio Sato
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引用次数: 0
摘要
一名 46 岁的男子患有急性 A 型主动脉夹层（TAAD），并接受了冷冻象鼻手术（FET）进行的全弓置换术。随访期间，我们发现背部疼痛，并通过计算机断层扫描在 FET 远端发现了远端支架移植物诱发的新入口（dSINE）。针对这一病理现象，我们又进行了扩大胸腔内血管主动脉修复术（TEVAR）。TAAD 修复术和 TEVAR 之间的间隔时间为 2 个月。我们通过dSINE前后的计算流体动力学分析研究了这一并发症。结果显示，真腔（TL）狭窄部位的管壁剪切应力增加，而FET部位的管壁剪切应力没有增加，这表明预狭窄流体动力负荷可能会影响dSINE的发生。
Case Report: Increase in wall shear stress in a narrowed true lumen after type A aortic dissection repair analyzed by computed fluid dynamics.
A 46-year-old man suffered from acute type A aortic dissection (TAAD) and underwent total arch replacement using the frozen elephant trunk (FET) procedure. During follow-up, we noted back pain and found distal stent graft-induced new entry (dSINE) at the FET distal part by computed tomography. We performed additional extended thoracic endovascular aortic repair (TEVAR) for this pathology. The time between TAAD repair and TEVAR was 2 months. We investigated this complication by computational fluid dynamics analysis through pre- and post-dSINE. The results showed increased wall shear stress at the narrowed true lumen (TL) site, not at the FET site, indicating that prestenotic hydrodynamic load may affect dSINE occurrence.
期刊介绍：
Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers?
At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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