Coronary malperfusion associated with aortic dissection is relatively rare,which has been reported at 5.7%-11.3%,[1]but when it occurs,it is fatal to the patient.Despite improved therapeutic techniques for aortic diss...Coronary malperfusion associated with aortic dissection is relatively rare,which has been reported at 5.7%-11.3%,[1]but when it occurs,it is fatal to the patient.Despite improved therapeutic techniques for aortic dissection over the years,surgical treatment for the uncommon condition of aortic dissection with coronary malperfusion is still premature.Prompt coronary revascularization and concomitant surgical repair of the aorta are essential for dealing with this problem.To date,the surgical management for this condition relies on various techniques,which include coronary artery bypass grafting （CABG） and repair coronary vessels.[1,2] However,the optimal surgical strategy for coronary revascularization is still debated.In this study,we reviewed our experience with aortic dissection involving the coronary artery in 36 patients,which evolved over a 14-year period,aiming to provide alternative options in the face of this scenario.展开更多
Case: A 55-year-old man without past medical histories suffering from back pain for two weeks was successfully resuscitated from an 8-min cardiopulmonary arrest (CPA) and was brought to our hospital by ambulance. Comp...Case: A 55-year-old man without past medical histories suffering from back pain for two weeks was successfully resuscitated from an 8-min cardiopulmonary arrest (CPA) and was brought to our hospital by ambulance. Computed tomography demonstrated type A acute aortic dissection (AAAD) with brachiocephalic artery occlusion. After admission, Glasgow Coma Scale score improved to E1VTM4, and voluntary movement was noted only in the right limbs. Outcome: The patient underwent emergency grafting of the ascending aorta and innominate artery under deep hypothermic circulatory arrest. After surgery, the patient recovered with mild disorientation and left hemiplegia. Magnetic resonance imaging of the head revealed no large infarction but revealed multiple acute ischemic changes. One year later, the patient demonstrated independent walk and successfully returned to work life. Conclusions: Immediate resuscitation and surgery resulted in good recovery from CPA after AAAD.展开更多
Umbilical cord(UC)embolism is a rare,life-threatening complication of pregnancy.The exact cause of this condition is not yet known.Women with more than one UC abnormality are at risk of UC obstruction;this condition c...Umbilical cord(UC)embolism is a rare,life-threatening complication of pregnancy.The exact cause of this condition is not yet known.Women with more than one UC abnormality are at risk of UC obstruction;this condition can lead to stasis,ischemia,and in some cases,thrombosis.However,many women with UC abnormalities remain undetected and may not be recognized until after birth.Here,we present a case involving the prenatal diagnosis and successful treatment of umbilical artery embolism in the third trimester with good maternal and fetal outcomes.The risk of UC embolism increases when more than one UC abnormality is identified in a single case.Ultrasound examination in the third trimester of pregnancy should be able to verify the existence of two arteries and one vein in the UC.If necessary,these results can be compared with ultrasound imaging acquired during the first trimester of pregnancy.展开更多
基金a grant from the National Natural Science Foundation of China
文摘Coronary malperfusion associated with aortic dissection is relatively rare,which has been reported at 5.7%-11.3%,[1]but when it occurs,it is fatal to the patient.Despite improved therapeutic techniques for aortic dissection over the years,surgical treatment for the uncommon condition of aortic dissection with coronary malperfusion is still premature.Prompt coronary revascularization and concomitant surgical repair of the aorta are essential for dealing with this problem.To date,the surgical management for this condition relies on various techniques,which include coronary artery bypass grafting （CABG） and repair coronary vessels.[1,2] However,the optimal surgical strategy for coronary revascularization is still debated.In this study,we reviewed our experience with aortic dissection involving the coronary artery in 36 patients,which evolved over a 14-year period,aiming to provide alternative options in the face of this scenario.
文摘Case: A 55-year-old man without past medical histories suffering from back pain for two weeks was successfully resuscitated from an 8-min cardiopulmonary arrest (CPA) and was brought to our hospital by ambulance. Computed tomography demonstrated type A acute aortic dissection (AAAD) with brachiocephalic artery occlusion. After admission, Glasgow Coma Scale score improved to E1VTM4, and voluntary movement was noted only in the right limbs. Outcome: The patient underwent emergency grafting of the ascending aorta and innominate artery under deep hypothermic circulatory arrest. After surgery, the patient recovered with mild disorientation and left hemiplegia. Magnetic resonance imaging of the head revealed no large infarction but revealed multiple acute ischemic changes. One year later, the patient demonstrated independent walk and successfully returned to work life. Conclusions: Immediate resuscitation and surgery resulted in good recovery from CPA after AAAD.
基金This study was funded by the National Health and Family Planning Commission Science Foundation(2019-WJ-04)the Guide Fund for the Development of Local Science and Technology from the Central Government(2020L3019).
文摘Umbilical cord(UC)embolism is a rare,life-threatening complication of pregnancy.The exact cause of this condition is not yet known.Women with more than one UC abnormality are at risk of UC obstruction;this condition can lead to stasis,ischemia,and in some cases,thrombosis.However,many women with UC abnormalities remain undetected and may not be recognized until after birth.Here,we present a case involving the prenatal diagnosis and successful treatment of umbilical artery embolism in the third trimester with good maternal and fetal outcomes.The risk of UC embolism increases when more than one UC abnormality is identified in a single case.Ultrasound examination in the third trimester of pregnancy should be able to verify the existence of two arteries and one vein in the UC.If necessary,these results can be compared with ultrasound imaging acquired during the first trimester of pregnancy.
