Tousek P, Krupicka J, Línková H, Straka Z, Koldová L, Widimský P
III.interní-kardiologická klinika 3. lékarské fakulty UK a FN Královské Vinohrady, Praha.
Vnitr Lek. 2004 Dec;50(12):939-42.
In this case we present a patient with unruptured non-coronary sinus of Valsalva aneurysm associated with diverse clinical findings, caused by acquired degenerative changes of the aortic wall. A previously healthy 36-year-old female was admitted to the neurological clinic of our hospital having suffered from an episode of unconsciousness prior to admission, with accompanying seizures. For the preceding two months she had also been suffering from dyspnoea and palpitation. Neurological examination, computed tomography of the head and electroencephalography were with normal findings. Thereafter, due to paroxysm of supraventricular tachycardia she was referred to cardiology clinic. On routine physical examination a diastolic murmur was detected and the patient was referred for transthoracic echocardiography. This examination revealed a large, unruptured noncoronary sinus of Valsalva aneurysm, which was thereafter confirmed by transoesophageal echocardiography a angiography. The patient was indicated for surgical correction with aortic valve and aortic root replacement by Bentall procedure. Histological examination of the part of resected aneurysm found cystic medial degeneration of the aortic wall, also called cystic medial necrosis.
在此病例中，我们呈现了一名患有未破裂的非冠状动脉窦瓦氏动脉瘤的患者，伴有多种临床症状，病因是主动脉壁的后天退行性改变。一名此前健康的36岁女性因入院前曾出现一次意识丧失并伴有癫痫发作而入住我院神经科。在之前的两个月里，她还一直遭受呼吸困难和心悸的折磨。神经检查、头部计算机断层扫描和脑电图检查结果均正常。此后，由于阵发性室上性心动过速，她被转诊至心脏病科门诊。在常规体格检查中发现了舒张期杂音，该患者被转诊进行经胸超声心动图检查。此项检查显示存在一个大的、未破裂的非冠状动脉窦瓦氏动脉瘤，随后经食管超声心动图和血管造影得以证实。该患者被建议采用Bentall手术进行主动脉瓣和主动脉根部置换的手术矫正。对切除的动脉瘤部分进行组织学检查发现主动脉壁呈囊性中层退变，也称为囊性中层坏死。
