Taguchi M, Konishi H, Shinohara T, Aizawa K, Takahashi H, Tateishi A, Sakano Y, Kaminishi Y, Ohki S, Saito T, Kawada M, Misawa Y
Division of Cardiovascular Surgery, Jichi Medical School, Shimotsuke, Japan.
Kyobu Geka. 2006 Nov;59(12):1103-5.
A 60-year-old woman had previously undergone aortic valve replacement for aortic regurgitation. As the aortic wall was elastic hard, inflammatory change was suspected; therefore, we undertook a partial biopsy of the ascending aortic wall and the intraoperative pathological specimens were compatible with aortitis syndrome. As there was no active inflammatory change, she was diagnosed as inactive aortitis syndrome and steroid therapy was not applied. Seven years later, a follow-up computed tomography (CT) showed an ascending aortic aneurysm of 65 mm in diameter. Aortic root replacement was planned based on a clinical diagnosis of an aneurysm of the ascending aorta. The patient was discharged without complication 21 days after surgery. It is possible that an inactive stage of aortitis may lead to late dilatation of the ascending aorta; therefore, careful postoperative follow-up is necessary in such cases.
一名60岁女性此前因主动脉瓣反流接受了主动脉瓣置换术。由于主动脉壁弹性变硬,怀疑有炎症改变;因此,我们对升主动脉壁进行了部分活检,术中病理标本符合大动脉炎综合征。由于没有活动性炎症改变,她被诊断为非活动性大动脉炎综合征,未应用类固醇治疗。七年后,随访计算机断层扫描(CT)显示升主动脉瘤直径为65mm。基于升主动脉瘤的临床诊断,计划进行主动脉根部置换。患者术后21天无并发症出院。非活动性大动脉炎阶段可能导致升主动脉晚期扩张;因此,在此类病例中术后需要仔细随访。