Int J Cardiol. 2011 Aug 4;150(3):e89-91. doi: 10.1016/j.ijcard.2009.11.029. Epub 2010 Jan 6.
A 69-year-old man was presented with a holosystolic and early diastolic murmur in cardiac auscultation, pretibial edema and elevated inflammation markers. Aortic valve and ascending aorta had been replaced 9 months earlier. Transesophageal echocardiography revealed massive eccentric regurgitation and dehiscence of the aortic valve, resulting in a giant circular false aneurysm with connection to the lumen of the aortic arch. CT and MR confirmed extensive leakage in a covered perforation. The false lumen was confined by a newly formed vessel wall, since the native Aorta ascendens had been excised. Smooth muscle cells expressing the progenitor marker CD34 were detected selectively in this region, indicating a contribution of circulating progenitor cells to the false vessel wall. After detection of Staphylococcus epidermidis in blood, another urgent Bentall operation was performed. However, the patient succumbed to right ventricular failure and multiple organ failure on postoperative day 1.
一位 69 岁男性在心脏听诊时出现全收缩期和舒张早期杂音、胫前水肿和炎症标志物升高。9 个月前曾行主动脉瓣和升主动脉置换术。经食管超声心动图显示主动脉瓣大量偏心性反流和裂开，导致与主动脉弓管腔相通的巨大圆形假性动脉瘤。CT 和 MR 证实覆盖穿孔处有广泛渗漏。由于已切除升主动脉，假腔由新形成的血管壁限制。在该区域选择性地检测到表达祖细胞标志物 CD34 的平滑肌细胞，表明循环祖细胞对假性血管壁的贡献。在血液中检测到表皮葡萄球菌后，再次紧急进行 Bentall 手术。然而，患者在术后第 1 天死于右心室衰竭和多器官衰竭。
