Bajaj Rishi, Mamidala Suresh, Bajaj Prabhjot, Kumar Deepti
Division of Cardiology, University of Massachusetts Medical School, Saint Vincent Hospital, Worcester, Massachusetts, USA.
BMJ Case Rep. 2013 Nov 6;2013:bcr2013200553. doi: 10.1136/bcr-2013-200553.
A 52-year-old man underwent two-dimensional echocardiogram which showed moderate to severe aortic regurgitation (AR) and dilated ascending aorta. CT angiography (CTA) showed dilated ascending aorta (5 cm) and transoesophageal echocardiogram revealed bicuspid aortic valve. He underwent cardiac catheterisation which revealed triple vessel aneurysmal disease of the left anterior descending, left circumflex and right coronary artery. The patient underwent aortic graft placement for ascending aortic aneurysm and aortic valve replacement with a Saint Jude valve for severe AR. There was no history or stigmata of Kawasaki disease and workup for coronary artery aneurysm including vasculitis and connective tissue disorders was negative. Histopathology did not reveal evidence of active aortitis or dissection. His aneurysms are being observed by a yearly coronary CTA. We present a rare case of multiple coronary artery aneurysms associated with bicuspid aortic valve and ascending aortic aneurysm.
一名52岁男性接受了二维超声心动图检查，结果显示中度至重度主动脉瓣反流（AR）以及升主动脉扩张。CT血管造影（CTA）显示升主动脉扩张（5厘米），经食管超声心动图显示二叶式主动脉瓣。他接受了心导管检查，结果显示左前降支、左旋支和右冠状动脉存在三支血管动脉瘤性疾病。该患者接受了升主动脉瘤主动脉移植物置入术，并因严重AR接受了圣犹达瓣膜主动脉瓣置换术。患者无川崎病病史或体征，针对冠状动脉瘤包括血管炎和结缔组织疾病的检查结果为阴性。组织病理学未发现活动性主动脉炎或夹层的证据。每年通过冠状动脉CTA对其动脉瘤进行观察。我们报告了一例罕见的与二叶式主动脉瓣和升主动脉瘤相关的多发性冠状动脉瘤病例。
