초록
개심술 이후 발생한 대동맥 피부 누공의 합병증은 드물지만 한 번 발생하면 매우 치명적이므로 빠른 진단과 수술적 치료가 요구된다. 국립의료원에서는 대동맥 판막과 승모판막 치환술 이후 4년 8개월 동안 흉골감염이 반복되다가 갑작스런 출혈로 응급실에 내원해서 대동맥 혈관 촬영술을 통해 대동맥 피부 누공을 진단하여 응급 체외순환하에 일차 봉합만으로 더 이상의 재발없이 2년간 외래 추적 관찰 중이다.
Aorto-cutaneous fistula is a rare complication after performing open heart surgery, but if this develops, it is a fatal condition. So, prompt diagnosis and aggressive surgical treatment is needed. We report here on a patient who had two mechanical double valves placed during heart surgery and she was treated for repeated sternal wound infections for about 5 years. She visited the ER due to abrupt bleeding at the sternal wound. She was diagnosed as having an aorto-cutaneous fistula by performing an aortogram and we then performed cardio-pulmonary bypass surgery. The patient is currently doing well and is under follow up 24 months after the repair.
