Thoracic endovascular aortic repair for hemolysis 17 years after insertion of classical elephant trunk: a case report

被引:0
|
作者
Mitsuishi, Atsuyuki [1 ]
Hirose, Nobuyuki [2 ]
Okamoto, Unpei [3 ]
Noguchi, Tatsuya [4 ]
Kawaguchi, Juri [4 ]
Miura, Yujiro [1 ]
机构
[1] Kochi Med Sch Hosp, Dept Cardiovasc Surg, 185-1 Kohasu,Okohcho, Nankoku, Kochi 7838505, Japan
[2] Izumino Hosp, Dept Cardiol, 2-10-53 Azono, Kitamachi, Kochi 7810011, Japan
[3] Kyoto Prefectual Hosp Med, Univ Hosp, Dept Cardiovasc Surg, 465 Kajiicho,Kamigyo Ku, Kyoto 6028566, Japan
[4] Kochi Med Sch Hosp, Dept Cardiol & Geriatr, 185-1 Kohasu,Okohcho, Nankoku, Kochi 7838505, Japan
关键词
Haemolysis; TEVAR; Classical elephant trunk; Aortic arch replacement; Aortic dissection; Calcification; DISSECTION;
D O I
10.1186/s13019-023-02415-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundThe classical elephant trunk (ET) technique is a very useful surgical procedure; however, haemolysis in the aorta associated with ET has been previously reported. It normally occurs within several years after the surgery, and it is a rare case of rapidly progressing haemolysis 10 or more years after aortic arch replacement with ET.Case presentationA 53-year-old man with a history of Stanford type A aortic dissection (DeBakey type Is), who was treated with total arch aortic replacement and aorto-femoral bypass using a prosthetic graft 17 years ago, developed severe progressive haemolytic anaemia. The ET used for the initial surgery was narrowed, and mechanical haemolysis was suspected. We assumed that progressive mechanical haemolysis occurred because of degeneration of the prosthetic graft. Thoracic endovascular aortic repair was performed, and haemolysis and anaemia were mitigated postoperatively.ConclusionsHaemolysis occurred 17 years after the initial surgery with ET. When haemolysis is suspected in a patient with ET, it must be identified as a cause of haemolysis even if 10 years or more have passed since the ET was inserted. To prevent this complication, attention should be paid to an appropriate ET length and diameter to avoid folding of the ET, particularly when the true cavity diameter is small.
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页数:6
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