42岁男性主动脉弓离断1例报告

Interrupted aortic arch in a 42-year-old man

主动脉弓离断是一种罕见的、婴幼儿期死亡率高的严重复杂畸形,能长大成人更为罕见。一位42岁男性高血压患者,经主动脉CT血管造影检查证实,降主动脉起始部血管与主动脉弓中断,邻近脊柱旁、肋间及胸背部皮下软组织内见多个扭曲紊乱血管团,并于降主动脉起始水平见数支血管汇入降主动脉CT血管造影。经降压治疗后,症状好转出院。本研究报道给我们的启示:对年轻高血压患者要仔细听诊,一旦前胸背部听到杂音,及时行CTA检查,避免漏诊和误诊。

Interrupted aortic arch is a rare congenital vascular malformation associated with a high mortality rate in infancy,and is therefore very unusual in adults.We report a case of interrupted aortic arch in a 42-year-old male hypertensive patient who was found to have a disruption of aorta continuity distal to the left subclavian artery with massive collateral circulation into the descending aorta by computed tomography angiography.The patient was discharged after the blood pressure was controlled by antihypertensive therapy.This case suggests the necessity of careful auscultation for young patients with hypertension.Once murmur in the chest and back is heard,computed tomography angiography should be performed at once to avoid missed diagnosis and misdiagnosis.