Center of Cardiac Surgery, Chelyabinsk, Russian Federation.
Ann Thorac Cardiovasc Surg. 2024 Jan 26;30(1). doi: 10.5761/atcs.cr.22-00236. Epub 2023 Mar 25.
A syphilitic aortitis is a late cardiovascular lesion of tertiary syphilis that has become exceptionally rare in the antibiotic era but not eradicated completely. Syphilitic aortitis of ascending aorta complicates in ascending aortic aneurysm formation and aortic valve regurgitation, both requiring surgical treatment. After surgery, lifelong surveillance of the remainder of the aorta is recommended because of a priori supposed high incidence of delayed involvement of noninvolved aortic segments. A 3-year follow-up result of surgery of syphilitic ascending aortic aneurysm with aortic valve regurgitation in condition of active ongoing syphilitic aortitis and valvulitis is described with addressing the dimensions of remaining aortic segments. This case demonstrates that the dilatation of the remainder of the aorta does not occur during 3 years, at least when anti-syphilitic course of antibiotic is used just after operation without additional treatment during the follow-up period. A few reports on surgical treatment of syphilitic aneurysms of the ascending aorta are discussed.
梅毒性主动脉炎是三期梅毒的一种晚期心血管病变,在抗生素时代已极为罕见,但并未完全根除。升主动脉梅毒性主动脉炎可并发升主动脉瘤形成和主动脉瓣反流,均需手术治疗。由于假设未受累主动脉节段的延迟受累发生率较高,手术后建议对其余主动脉进行终身监测。本文描述了一例梅毒性升主动脉瘤伴主动脉瓣反流患者,在梅毒性主动脉炎和主动脉瓣炎活动期进行手术治疗的 3 年随访结果,并讨论了剩余主动脉节段的大小。该病例表明,至少在术后立即使用抗梅毒抗生素疗程,而在随访期间不进行额外治疗的情况下,在 3 年内,主动脉其余部分不会扩张。本文还讨论了几篇关于升主动脉梅毒性动脉瘤的手术治疗报告。