Dinis da Gama A, Matias Rosa
Clinica Universitária de Cirurgia Vascular do H. St. Maria, Centro Hospitalar de Lisboa Norte.
Rev Port Cir Cardiotorac Vasc. 2010 Jan-Mar;17(1):35-42.
Vascular Ehlers-Danlos syndrome is a rare genetic and hereditary disorder that affects and weakens the structure and sustentability of medium and large size arteries, causing severe clinical complications, often fatal, such as is the case of spontaneous ruptures, aneurysms or arterial dissections. Concomitantly, spontaneous intestinal perforations may occur, as well as uterine ruptures, following a pregnancy and during the peripartum period. The authors report the clinical cases of three young females of the same family, with the diagnosis of vascular Ehlers-Danlos syndrome, coursing with severe involvement of the aorta (ascending aortic anerysm, dissection of the thoracoabdominal aorta), who underwent successful surgical management and were evaluated from 6 to 18 years after the operations. To complete the clinical presentation of the cases, the authors review the most recent literature and discuss the main features of this entity, namely its genetic origin, the arterial morphology and structural alterations, its clinical expression, the diagnosis and the challenges faced by the therapeutical approach, wether it would be the conventional arterial reconstructive surgery or the most recently introduced endovascular intervention.
血管型埃勒斯-当洛综合征是一种罕见的遗传疾病,会影响并削弱中大型动脉的结构和支撑性,引发严重的临床并发症,常常是致命的,比如自发性破裂、动脉瘤或动脉夹层。同时,还可能出现自发性肠穿孔,以及怀孕和围产期的子宫破裂。作者报告了同一家族中三名年轻女性的临床病例,她们被诊断为血管型埃勒斯-当洛综合征,主动脉严重受累(升主动脉瘤、胸腹主动脉夹层),她们接受了成功的手术治疗,并在术后6至18年接受了评估。为完善这些病例的临床表现,作者回顾了最新文献,并讨论了该疾病的主要特征,即其遗传起源、动脉形态和结构改变、临床症状、诊断以及治疗方法所面临的挑战,无论是传统的动脉重建手术还是最近引入的血管内介入治疗。