一例升主动脉穿透性动脉粥样硬化溃疡破裂的尸检诊断罕见病例。

A rare case of postmortem diagnosis of penetrating atherosclerotic ulcer rupture in the ascending aorta.

作者信息

Tornese Lorenzo, Cianci Vincenzo, Sapienza Daniela, Bartoloni Giovanni, Gualniera Patrizia, Asmundo Alessio, Mondello Cristina

机构信息

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Legal Medicine, University of Messina, via Consolare Valeria, 1, Messina, 98125, Italy.

Department of Anatomy, Diagnostic Pathology, Legal Medicine Hygiene and Public Health, University of Catania, Catania, Italy.

出版信息

Forensic Sci Med Pathol. 2025 Jun 20. doi: 10.1007/s12024-025-01034-3.

DOI:10.1007/s12024-025-01034-3

PMID:40540166

Abstract

A 74-year-old man underwent both a mitral valve replacement and ascending aorta replacement because of the presence of a critical aneurysm. Postoperatory CT angiography revealed both a periprosthetic hematoma of about 40 mm located at the distal prosthetic graft and a modest effusion at the base of the pericardium. 12 days after the surgery the patient suddenly died. Autopsy showed a cardiac tamponade due to ascending aorta rupture secondary to penetrating atherosclerotic ulcer (PAU). This paper highlights the key gross and microscopic findings of this rare lesion, emphasizing its forensic pathology relevance.

摘要

一名74岁男性因严重动脉瘤接受了二尖瓣置换术和升主动脉置换术。术后CT血管造影显示，在人工血管远端有一个约40毫米的人工瓣膜周围血肿，心包底部有少量积液。术后12天，患者突然死亡。尸检显示因穿透性动脉粥样硬化溃疡（PAU）继发升主动脉破裂导致心脏压塞。本文重点介绍了这种罕见病变的关键大体和微观表现，强调了其法医病理学相关性。