Yang Guoliang, Lai Xiaoyue, Liang Chunshui, Fan Weijie, Fu Wanlei, Liu Zheng, Xia Hongmei
Department of Ultrasound, Xinqiao Hospital, Army Medical University, Chongqing, China.
Department of Cardiac Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China.
Front Cardiovasc Med. 2023 Mar 3;10:1036476. doi: 10.3389/fcvm.2023.1036476. eCollection 2023.
The aortic bulge sign possibly indicates an arterial aneurysm, pseudoaneurysm, aortic dissection, or aortic diverticulum. The aortic diverticulum is a congenital abnormality of the aorta, mainly known as an aneurysmal remnant of the dorsal fourth aortic arch or ductus arteriosus. However, the diverticulum of another part of the aorta has rarely been reported.
We report a case of a 24-year-old male with a history of oral ulcer presented with recurrent hyperpyrexia and chest pain. Echocardiography and computed tomography showed the anomalous origin of the coronary arteries, aortic valve vegetations, and a bulge at the aortic root. The patient then received a Bentall procedure. The aorta and aortic valves were replaced by a valved conduit. The bulge with a normal arterial wall at the aortic root was considered to be a diverticulum. The infective endocarditis was verified as a secondary oral-derived streptococcal infection. The patient was discharged 15 days after surgery. Post-operative echocardiography had no positive findings.
Our case report highlights the role of multimodal cardiovascular imaging for the diagnostic workup of rare disorders, such as the presence of a diverticulum in the aortic root in a patient with endocarditis and anomalous origin of the right coronary artery.
主动脉膨出征可能提示动脉动脉瘤、假性动脉瘤、主动脉夹层或主动脉憩室。主动脉憩室是主动脉的一种先天性异常，主要被认为是第四对背主动脉弓或动脉导管的动脉瘤残余。然而，主动脉其他部位的憩室鲜有报道。
我们报告一例24岁男性，有口腔溃疡病史，出现反复高热和胸痛。超声心动图和计算机断层扫描显示冠状动脉起源异常、主动脉瓣赘生物以及主动脉根部膨出。该患者随后接受了Bentall手术。用带瓣管道替换了主动脉和主动脉瓣。主动脉根部膨出且动脉壁正常，被认为是一个憩室。感染性心内膜炎经证实为继发于口腔的链球菌感染。患者术后15天出院。术后超声心动图未发现阳性结果。
我们的病例报告强调了多模态心血管成像在罕见疾病诊断检查中的作用，例如在心内膜炎和右冠状动脉起源异常患者中主动脉根部存在憩室的情况。
