[右主动脉弓伴左锁骨下动脉异常的Kommerell憩室两期修复1例]。

Q4 Medicine
Takeshi Sakaguchi, Ryo Hirayama, Mai Matsukawa, Kenta Uekihara, Syuichi Urashita, Tomoya Miyamoto, Takenori Kojima, Ryusuke Suzuki
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引用次数: 0

摘要

一名52岁妇女以进食时吞咽困难及咳嗽为主诉转介至我院。增强CT显示Kommerell憩室伴右主动脉弓和左锁骨下动脉异常。憩室压迫食道和气管。我们避免了全主动脉弓置换术,因为有循环骤停、选择性脑灌注和包括喉返神经损伤在内的神经系统并发症的风险。因此,我们计划对憩室进行两期修复。首先,我们进行了腋窝-腋窝动脉搭桥术和左锁骨下动脉线圈栓塞术。7天后,行降主动脉置换术,包括憩室合并右侧前外侧第三肋间开胸和下体部分体外循环。术后过程顺利,患者在初次手术后20天出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Two-stage Repair of Kommerell Diverticulum with Right Aortic Arch and Aberrant Left Subclavian Artery:Report of a Case].

A 52-year-old woman was referred to our hospital with a chief complaint of difficulty in swallowing and coughing while eating. Enhanced computed tomography (CT) revealed a Kommerell diverticulum with right aortic arch and aberrant left subclavian artery. The diverticulum compressed the esophagus and trachea. We avoided total aortic arch replacement because there were risks of circulatory arrest, selective cerebral perfusion and neurological complication including injury to recurrent laryngeal nerve. Therefore, we scheduled two-stage repair of the diverticulum. First, we performed axillo-axillary artery bypass and left subclavian artery coil embolization. After 7 days, descending aorta replacement including a diverticulum with right anterior lateral 3rd intercostal thoracotomy and lower body partial extracorporeal circulation was performed. The postoperative course was uneventful and she was discharged 20 days after the initial surgery.

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