Jayle C, Denis C, Saïs T, Charrière J M, Menu P, Piette J C, Corbi P
Département médico-chirurgical de cardiologie, unité de chirurgie thoracique et cardiaque, pavillon Beauchant, BP 577, Cité hospitalière la Milétrie, CHRU de Poitiers, 86021 Poitiers.
Arch Mal Coeur Vaiss. 2002 Oct;95(10):955-8.
Takayasu's disease is rare in Western countries. It is most often revealed by stenosing lesions, aneurysmal attacks being less frequent, generally multifocal, and associated with stenoses. An isolated aneurysmal attack of the ascending aorta is exceptional. It is a deleterious factor in the disease process, and one of the causes of death in this disease. We report a case of isolated aneurysm of the ascending aorta extending to the aortic arch, undergoing emergency surgery at the rupture phase, revealing Takayasu's arteritis. Classically, isolated, asymptomatic, small aneurysms without lesions of other branches are slow to evolve with prolonged corticosteroid therapy. Our observation was contrary to these data, with rapid growth in a major inflammatory context, and rupture. It would seem important to rapidly diagnose and treat Takayasu's disease aneurysms of the ascending aorta, given their progressive potential. In a young female the signs of parietal thickening of the aneurysm must provoke diagnosis and treatment rapidly.
高安氏病在西方国家较为罕见。它最常表现为狭窄性病变,动脉瘤发作相对较少见,通常为多灶性,并伴有狭窄。升主动脉孤立性动脉瘤发作极为罕见。它是疾病进程中的有害因素,也是该疾病的死亡原因之一。我们报告一例升主动脉孤立性动脉瘤延伸至主动脉弓的病例,该病例在破裂期接受了急诊手术,确诊为高安氏动脉炎。典型情况下,孤立、无症状、无其他分支病变的小动脉瘤在长期使用皮质类固醇治疗下进展缓慢。我们的观察结果与这些数据相反,该动脉瘤在严重炎症背景下迅速生长并破裂。鉴于升主动脉高安氏病动脉瘤具有进展的可能性,快速诊断和治疗似乎很重要。对于年轻女性,动脉瘤壁增厚的体征必须促使迅速进行诊断和治疗。