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To investigate the clinical features of hypertension caused by aortic stenosis, a more precise of diagnosis of aortic stenosis and safe and effective surgical treatment to improve the patients's clinical features of the disease.
observed the patients clinical manifestations, imaging and related literature and we summarized the treatment of aortic stenosis.
The patient, 44 years old, male, three years ago, has no obvious inducement to have hypertension, the highest blood pressure is 180/90 mmHg, no dizziness, headache, chest pain, chest tightness and other symptoms. At a local hospital he was diagnosed with hypertension, but didn't regularly take anti -hypertensive drugs. In the month of March he felt fatigue after activities like climbing the stairs and had a sense of chest tightness, he needed to take a break to relieve the tightness. October 2015, at a local hospital after appendectomy, the blood pressure was up to 210/120mmHg, and with other therapyed increased metering, the effect is not obvious, except with chest tightness, the lower extremities accompanied by numbness, cold, and thearterial pulse on the foot was weak, aortic dissection was considered. The aortic CTA shows: 1. Aortic isthmus (aortic arch below) with partial luminal narrowing significantly, and after narrowing thoracic aortic lumen. The limitations of local area showed mild expansion, multiple collateral vessel formation. 2. The lower thoracic aorta, abdominal aorta and bilateral iliac artery trunk diameter were thinner. The patient was transferred to our hospital cardiac surgery department. Physical Examination: T: 36.5 °C P: 100 beats/min R: 20 beats/min BP: 170/85mmHg. left carotid artery pulse obviously, 3/6 murmur could be heard in the second aortic systolic auscultation, femoral artery fluctuations, thin, and the temperature of the lower limbs significantly was lower than the upper limbs. Echocardiography: hypertensive heart change descending aortic coarctation caused by the left subclavian end descending aortic isthmus stenosis flow and probe beams. ECG: Complete left bundle branch block Diagnosis: 1. aortic stenosis (aortic arch below) 2 hypertension grade 3 very high-risk group. 2015-12-21 it was perfermed the ascending aorta - the descending aorta bypass surgery. By descending aorta graft line-artificial blood vessel anastomosis proximal end side of the ascending aorta with artificial blood vessels aortic anastomosis side to lift the hypertension caused by aortic stenosis, postoperative blood pressure 140/85mmHg, normal blood pressure after follow-up.
During hypertension caused by aortic stenosis and using anti-hypertensive drugs as treatment is mostly ineffective. Surgery is needed and artery bypass grafting operation is simple and effective with few complications.