一例经食道超声心动图诊断的主动脉肺瘘伴术后主动脉假性动脉瘤病例

IF 1.2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Katsunori Fukumoto, Yuki Saito, Tetsuro Yumikura, Makoto Taoka, Masashi Tanaka, Yasuo Okumura
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引用次数: 0

摘要

主动脉手术后出现气管支气管瘘或食管瘘的报道在文献中时有发生,但主动脉假性动脉瘤术后伴发主动脉肺瘘的报道却很少见。我们经历了一例因主动脉假性动脉瘤术后伴发主动脉肺动脉瘘而导致的难治性心力衰竭。一名 60 岁的男性在 2 年前接受了主动脉手术,因充血性心力衰竭住院治疗。在接受了 10 天的利尿剂治疗后,他的病情仍不见好转,被诊断为难治性心力衰竭。他接受了造影剂增强计算机断层扫描(CT),怀疑升主动脉手术吻合口处的主动脉假性动脉瘤导致肺动脉穿孔。经食道超声心动图显示,主动脉瘤的分流血流进入右肺动脉,最终确诊为主动脉肺瘘伴术后主动脉假性动脉瘤。计算机断层扫描血管造影通常用于诊断主动脉瘘,但由于造影结果不明显,诊断往往比较困难。我们强调了经食道超声心动图在提供明确诊断和有关该病理生理学的详细形态学信息方面的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case of Aortopulmonary Fistula with Post-Operative Aortic Pseudoaneurysm Diagnosed by Transesophageal Echocardiography

Tracheobronchial or esophageal fistula after aortic surgery has been reported sporadically in the literature, however, reports of an aortopulmonary fistula associated with a post-operative aortic pseudoaneurysm are rare. We experienced a case of refractory heart failure due to an aortopulmonary fistula associated with a post-operative aortic pseudoaneurysm. A 60-year-old man who had undergone aortic surgery 2 years earlier was hospitalized for congestive heart failure. He was diagnosed with refractory heart failure after 10 days of diuretic therapy failed to improve his condition. He underwent a contrast-enhanced computed tomography (CT) scan and was suspected to have pulmonary artery perforation of an aortic pseudoaneurysm at the anastomotic site of the ascending aortic surgery. Transesophageal echocardiography showed shunt blood flow from the aortic aneurysm into the right pulmonary artery, leading to a definitive diagnosis of aortopulmonary fistula with post-operative aortic pseudoaneurysm. Computed tomography angiography is commonly used to diagnose an aortic fistula; however, diagnosis is often difficult because of the subtle imaging findings. We highlight the usefulness of transesophageal echocardiography in providing a definitive diagnosis and detailed morphologic information on this pathophysiology.

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来源期刊
International heart journal
International heart journal 医学-心血管系统
CiteScore
2.50
自引率
6.70%
发文量
148
审稿时长
6-12 weeks
期刊介绍: Authors of research articles should disclose at the time of submission any financial arrangement they may have with a company whose product figures prominently in the submitted manuscript or with a company making a competing product. Such information will be held in confidence while the paper is under review and will not influence the editorial decision, but if the article is accepted for publication, the editors will usually discuss with the authors the manner in which such information is to be communicated to the reader.
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