Picard R, Benit C, Chotard Y, du Quang L, Laparre F, Picard C, Duboc D, Guérin F
Service de Médecine interne, hôpital Louis-Mourier, Colombes.
Arch Mal Coeur Vaiss. 1987 Sep;80(10):1547-50.
The natural history of an incomplete spontaneous rupture of the ascending aorta over a 4-year period is reported. The initial presentation was subacute pericarditis which regressed spontaneously. Aortic regurgitation developed on the 100th day of the disease and was perfectly well tolerated haemodynamically for 4 years. This favourable course was interrupted by type I aortic dissection. The post-mortem examination provided an explanation for the peculiar development and course of the aortic regurgitation: it was due not to the usual prolapse of the cups but to displacement of the left posterior commissure by the retractile fibrosis arising from the lower lip of the spontaneous rupture.
本文报告了升主动脉不完全性自发性破裂在4年期间的自然病程。最初表现为亚急性心包炎,后自发消退。在病程第100天时出现主动脉反流,血流动力学上在4年里耐受良好。这一良好病程被I型主动脉夹层打断。尸检对主动脉反流的特殊发展和病程给出了解释:它并非由常见的瓣膜叶脱垂引起,而是由自发性破裂下唇处的收缩性纤维化导致左后联合移位所致。