Two-stage surgery for acute type B aortic dissection and aortic root aneurysm in a patient with Turner syndrome: a case report.

Kazunori Sakaguchi, Hidekazu Nakai, Takanori Tsujimoto, Atsunori Kono, Yojiro Koda, Katsuhiro Yamanaka, Kenji Okada
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Abstract

Background: Patients with Turner syndrome are at high risk of aortic dissection and are more likely to present with fatal outcomes. Turner syndrome is classified as a heritable thoracic aortic disease in the latest EACTS/STS guidelines. Herein, we present a case of two-staged surgery for acute type B aortic dissection and aortic root aneurysm in a patient with Turner syndrome.

Case presentation: A 29-year-old female patient with Turner syndrome was admitted to our center due to back pain and was diagnosed with acute type B aortic dissection. Echocardiography revealed a dilated aortic root with bicuspid aortic valve. On the 5 th day after admission, the patient presented with a higher level of back pain. Follow-up computed tomography scan revealed changes from two- to three-channel aortic dissection a further aortic dilation. Therefore, descending aorta and partial aortic arch replacement were initially performed. Then, valve-sparing aortic root replacement and residual arch replacement were performed 3 months after the first surgery. Postoperative echocardiography confirmed the absence of aortic regurgitation. The patient was discharged on the 17th postoperative day without any complications.

Conclusions: Two-stage surgery was successfully performed for the thoracic aorta and aortic root aneurysms in a patient with Turner syndrome. The patient recovered for 3 months after the left thoracotomy surgery and underwent a two-stage surgery through a median sternotomy surgery with good surgical results.

特纳综合征患者急性B型主动脉夹层和主动脉根部动脉瘤的两阶段手术:1例报告。
背景:特纳综合征患者发生主动脉夹层的风险较高,且更有可能出现致命的结局。在最新的EACTS/STS指南中,Turner综合征被归类为遗传性胸主动脉疾病。在此,我们提出一个两阶段的手术治疗急性B型主动脉夹层和主动脉根部动脉瘤的病人特纳综合征。病例介绍:一名29岁的特纳综合征女性患者因背部疼痛入院,诊断为急性B型主动脉夹层。超声心动图显示主动脉根部扩张,主动脉瓣为二尖瓣。入院后第5天,患者背部疼痛加重。随后的计算机断层扫描显示从二通道到三通道主动脉夹层的变化和进一步的主动脉扩张。因此,首先行降主动脉和部分主动脉弓置换术。第一次手术后3个月行保留瓣膜的主动脉根置换术和残余弓置换术。术后超声心动图证实无主动脉反流。患者于术后第17天出院,无并发症。结论:对1例特纳综合征患者的胸主动脉和主动脉根动脉瘤进行了成功的两期手术治疗。患者左开胸术后恢复3个月,经胸骨正中切开术两期手术,手术效果良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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