Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos Clínicos

Autores/as

  • Roberto González L Cirujano Cardiotorácico, Centro Cardiovascular, Hospital Clínico Regional de Concepción: "Dr. Guillermo Grant Benavente", Concepción, Chile. Departamento de Cirugía, Facultad de Medicina, Universidad de Concepción, Concepción, Chile.
  • Aleck Stockins L
  • Enrique Seguel S
  • Andrés Jadue T
  • Alejandra Riquelme U
  • Jorge Canales Z
  • Alberto Fuentes E
  • Emilio Alarcón C

Palabras clave:

Aorta, Aortic Diseases, Thoracic Surgery

Resumen

Penetrating aortic ulcer (PAU) is an ulceration of an atherosclerotic plaque which disrupts the aortic internal elastic lamina and that can evolve to an intramural hematoma (IH), aortic dissection or aortic rupture. We report two cases with PAU. A 73-years-old-woman with a history of hypertension, presented with acute chest pain of three days of evolution and a hypertensive emergency. An electrocardiogram showed ST-segment elevation and elevated cardiac enzymes. Computed tomography (CT) scans showed and acute ascending aortic mural hematoma secondary to PAU and hemopericardium. Replacement of ascending aorta was performed with a vascular prosthesis with extracorporeal circulation (ECC). PAU and IH were confirmed by histopathology. A 62-years-old woman with a history of hypertension, diabetes and chronic obstructive pulmonary disease, consulted for abdominal pain of two days of evolution. A thoracic-abdominal CT scan visualized an uncomplicated PAU and an abdominal aortic aneurysm. Because of abdominal pain and signs of peritoneal irritation, an exploratory laparotomy was performed finding a typhlitis. Resection and ileo-ascendo-anastomosis were performed. A new CT scan showed PAU with high risk of rupture without a clinical acute aortic syndrome. The patient was operated replacing the ascending aorta with a vascular prosthesis using ECC. Three PAU were found. Histopathology confirmed the diagnosis. Both patients evolved without postoperative complications.

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Publicado

2017-12-18

Cómo citar

González L, R., Stockins L, A., Seguel S, E., Jadue T, A., Riquelme U, A., Canales Z, J., Fuentes E, A., & Alarcón C, E. (2017). Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos Clínicos. Revista Médica De Chile, 145(11). Recuperado a partir de https://revistamedicadechile.cl/index.php/rmedica/article/view/6175

Número

Sección

Reporte de Caso Clínico

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