Résumé
Surgery is the general treatment modality for thoracic aortic pseudoaneurysm combined with traumatic aortic rupture. However, we should select other treatment modalities for patients who can't tolerate surgery due to severe multiple injuries. Herein we report on a case of successful stent-graft treatment for a traumatic descending thoracic aortic pseudoaneurysm combined with severe multiple trauma, and we include a review of the relevant literature.
Sujets)
Humains , Faux anévrisme , Rupture aortique , Polytraumatisme , Rupture , EndoprothèsesRésumé
A 49-year-old woman had thoracic back pain for several years. Chest CT scan and MRI angiography revealed descending thoracic aortic aneurysm with a maximum diameter of 69 mm. Thoracic aortography showed not only the aortic aneurysm, but also coarctation of descending thoracic aorta at the level of aortic hiatus of the diaphragm. Intercostal artery arising Adamkiewicz artery was found in descending thoracic aortic aneurysm just above the coarctation. The aneurysm with coarctation of the aorta was successfully repaired with prosthetic graft replacement under left atrio-femoral bypass.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Anévrysme , Aorte thoracique , Anévrysme de l'aorte , Anévrysme de l'aorte thoracique , Coarctation aortique , Aortographie , Artères , Dorsalgie , Muscle diaphragme , Angiographie par résonance magnétique , Tomodensitométrie , TransplantsRésumé
In patient with severe adhesion between lung and aorta, there is some limitation in approaching the distal arch or descending thoracic aorta through the usual left thoracotomy. We report a case of a successfully managed distal arch and descending thoracic aortic aneurysm through the median sternotomy without any manipulations of the lung in a 66 year old man who presented hemoptysis.
Sujets)
Sujet âgé , Humains , Aorte , Aorte thoracique , Anévrysme de l'aorte thoracique , Hémoptysie , Poumon , Sternotomie , ThoracotomieRésumé
Chronic irritation to arterial wall by foreign material may give rise to delayed vascular injury. A 50 years old male patient with kyphoscoliosis had undergone fixation of orthopedic Cotrel-Dubousset(CD) rods and screws. Fourteen months after that surgery, a false aneurysm of the descending thoracic aorta associated with pulsating hematoma in the muscular chest wall developed. The false aneurysm was managed by resecting the diseased aortic segment and replacing the vascular graft.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Faux anévrisme , Aorte thoracique , Hématome , Orthopédie , Rachis , Paroi thoracique , Transplants , Lésions du système vasculaireRésumé
We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms revealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardio- pulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.