Atypical Middle Aortic Syndrome in a Middle Aged Woman -A case report-

중년 여자 환자에서 비전형적 Middle Aortic Syndrome의 수술치험 1예

  • Published : 2004.01.01

Abstract

The aortic coarctation is located in the distal thoracic aorta or abdominal aorta, or both and is often called ‘middle aortic syndrome’ or ‘mid-aortic dyspastic syndrome’. Etiology is controversial and most cases are seen in young female women. Severe complication such as cardiac or renal dysfunction as well as cerebral hemorrhage may occur, so aggressive surgical intervention may take effect. Lately we experienced a middle aortic syndrome which was not typical because of the patient's advanced age at the time of clinical presentation. The Axillo-femoral artery bypass graft with 6 mm PTFE vascular graft was done.

원위 흉부 대동맥이나 복부 대동맥 혹은 두 부위가 좁아져 있는 Middle aortic syndrome (이하 MAS) 또는 mid aortic dysplastic syndrome은 매우 드물게 발생한다. 원인이 불분명하고 흔히 젊은 여성에게서 잘 나타나는 이 질환은 뇌출혈뿐만 아니라 심장, 신장의 손상을 초래할 수 있으므로 적극적인 수술적 치료로 혈류를 개선하여 효과를 볼 수 있으나 대동맥 혈관의 섬유화로 인한 수술 술기의 어려움이 따른다. 최근 국립의료원 흉부외과에서는 광범위한 석회화 병변을 동반한 하부 대동맥협착을 가진 51세 여자 환자에서 6.0-mmPTFE (polytetrafluoroethylene) 인조혈관을 이용하여 양측 액와-대퇴 동맥간 우회로술을 시행함으로써 우수한 수술 결과를 보였기에 보고하는 바이다.

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References

  1. Br Heart J v.25 The Middle aortic syndrome Sen,P.K.;Kinare,S.G.;Engineer,S.D.(et al.) https://doi.org/10.1136/hrt.25.5.610
  2. Ann Sur v.204 Middle aortic syndrome-effectiveness and durability of complex arterial revascularization techniques Messina,L.M.;Goldstone,J.;Ferrel,L.D.;Reilly,L.M.;Ehrenfeld,W.K. https://doi.org/10.1097/00000658-198609000-00012
  3. Thorax v.36 Middle aortic syndrome as a cause of heart failure in children and its management Gupta,S.;Goswani,B.;Ghosh,D.C.;Gupta,A.N.S. https://doi.org/10.1136/thx.36.1.63
  4. Am Coll Surg v.194 Middle aortic syndrome; distal thoracic and abdominal coarctation, a disorder with multiple etiologies John,E.;Samuel,E.;Peter,L.;Roy,M. https://doi.org/10.1016/S1072-7515(02)01144-4
  5. Eur Vasc Endovasc Surg v.18 Middle aortic syndrome: some diagnostic and therapeutic considerations Petrunic,M.;Tonkovic,I.;Grabic,D.;Popovic,L.;Radanovic,B.;Kruzic,Z. https://doi.org/10.1053/ejvs.1998.0724
  6. Korean Vascular Surg v.11 Middle aortic syndrome: Report of 4 cases Kim,S.;Ha,J.W.
  7. J Vasc Surg v.12 Crietria for the classification of Takayasu arteritis Areud,W.P.;Micheal,B.A.;Bloch,D.A.(et al.) https://doi.org/10.1067/mva.1990.23183
  8. J Am Coll Cardiol v.12 Diagnostic approach and proposed criteria for the clinical diagnosis of Takayasu's arteriopathy Ishikawa,K. https://doi.org/10.1016/0735-1097(88)90462-7