Yoshida Tetsuya, Oi Keiji, Shinohara Naohiro, Mihara Akane, Yokoyama Kenji
Department of Cardiovascular Surgery, Hokushin General Hospital, Nakano, Japan.
Kyobu Geka. 2013 Dec;66(13):1196-8.
We report a case of Takayasu's arteritis who underwent emergency surgery. A 39-year-old female presented with severe back pain. Electrocardiogram demonstrated complete atrio-ventricular (AV) block and acute inferior myocardial infarction. Coronary angiography revealed ostial occlusion of the right coronary artery. Aortography and contrast-enhanced computed tomography revealed dilated and bizarre-shaped aortic root. The remainder of the aorta and its branches appeared normal. She underwent emergency aortic root replacement with valved conduit. Coronary artery bypass grafting to right coronary artery( RCA) using saphenous vein graft was performed concomitantly. Histologic findings of the aortic root were compatible with Takayasu's arteritis. Postoperative angiography showed graft patency. Takayasu arteritis should be considered for differential diagnosis of acute myocardial infarction in young woman.
我们报告一例接受急诊手术的高安动脉炎患者。一名39岁女性因严重背痛就诊。心电图显示完全性房室传导阻滞和急性下壁心肌梗死。冠状动脉造影显示右冠状动脉开口闭塞。主动脉造影和增强计算机断层扫描显示主动脉根部扩张且形状怪异。主动脉及其分支的其余部分看起来正常。她接受了带瓣管道的急诊主动脉根部置换术。同时使用大隐静脉移植进行了右冠状动脉搭桥术。主动脉根部的组织学检查结果与高安动脉炎相符。术后血管造影显示移植血管通畅。对于年轻女性急性心肌梗死的鉴别诊断应考虑高安动脉炎。
