迷走右锁骨下动脉合并主动脉夹层1例.pdfVIP

·310 ·中华老年多器官疾病杂志 2015年4月28 日 第14卷 第4期 Chin J Mult Organ Dis Elderly, Vol.14, No.4, Apr 28, 2015 ·临床病理讨论 · 迷走右锁骨下动脉合并主动脉夹层1例 1 1 1 2* 2* 贺红艳 ，王树鸿 ，夏晓霞 ，田万管 ，孟庆义 1 2 （解放军总医院：健康管理研究院一病区，急诊科，北京 100853 ） 【摘 要】迷走右锁骨下动脉 （ARSA ）是发自降主动脉近端较常见的主动脉弓大血管异常。ARSA在起始部位可出现 内膜撕裂而导致主动脉夹层的发生，从而引起血流受限和后期的动脉瘤样变性。笔者报道了1例起源于ARSA 的急性A 型主动脉夹层。ARSA合并A型主动脉夹层实属罕见，术前经CT血管造影 （CTA ）得以确诊，CTA对本病进行外科治疗 决策非常有价值。临床医师应对迷走右锁骨下动脉合并主动脉夹层引起注意，以做到早期诊断，早期处理。 【关键词】迷走右锁骨下动脉；主动脉夹层 【中图分类号】 R543.1 【文献标识码】 A 【DOI 】 10.11915/j.issn.1671 -5403.2015.04.071 Aortic dissection in presence of an aberrant right subclavian artery: a case report 1 1 1 2* 2* HE Hong-Yan , WANG Shu-Hong , XIA Xiao-Xia , TIAN Wan-Guan , MENG Qing-Yi 1 2 ( The First Ward, Institute of Health Management; Department of Emergency, Chinese PLA General Hospital, Beijing 100853, China) 【Abstract 】 The presence of an aberrant right subclavian artery (ARSA) arising from the proximal descending aorta is a relatively common anomaly of the aortic arch. These vessels may be involved in aortic dissections, either as the site of the primary intimal tear or as a dissected aortic branch, subject to flow limitation and future aneurysmal degeneration. We report a case involving a ruptured acute type A aortic dissection originating from ARSA . The coincidence of an ARSA with a complicated acute type A aortic dissection is extremely rare, as in the present case. This case was diagnosed preoperatively by computed tomography angiography (CTA), which is of great value for precise planning of surgical strategy in such cases. The aim of the case