Zhao Hang, He Ben, Shen Xuedong, Qiao Zhiqing, Xu Tingyan, Lian Feng, Xue Song
Cardiology Department, Renji Hospital, Medical College of Shanghai Jiao-Tong University, Shanghai 200127, China.
J Clin Ultrasound. 2014 Jan;42(1):59-62. doi: 10.1002/jcu.22028. Epub 2013 Jan 12.
Behçet's disease (BD) is a multi-system inflammatory disorder. We report the case of a BD patient with severe aortic root vasculitis. Two-dimensional transthoracic echocardiography (2DE) images suggested left Valsalva sinus aneurysm ruptured into the left ventricular outflow tract. However, preoperative transesophageal real-time 3-dimensional echocardiography (3DE) revealed that the aneurysm-like structure involved most of the left ventricular outflow tract wall, leading to the diagnosis of aortic root dissection associated with perforation of the left Valsalva sinus and prolapse of the exfoliated endocardium into the left ventricular outflow tract. These findings were confirmed by open heart surgery. 3DE was helpful differentiating aortic root dissection from Valsalva sinus aneurysm rupture, especially by demonstrating the extent of aneurysm-like structure in the left ventricular outflow tract.
白塞病（BD）是一种多系统炎症性疾病。我们报告了一例患有严重主动脉根部血管炎的BD患者。二维经胸超声心动图（2DE）图像提示左瓦尔萨尔瓦窦瘤破裂进入左心室流出道。然而，术前经食管实时三维超声心动图（3DE）显示，瘤样结构累及左心室流出道壁的大部分，从而诊断为与左瓦尔萨尔瓦窦穿孔及剥脱的心内膜脱垂至左心室流出道相关的主动脉根部夹层。这些发现经心脏直视手术得到证实。3DE有助于区分主动脉根部夹层与瓦尔萨尔瓦窦瘤破裂，尤其是通过显示左心室流出道瘤样结构的范围。
