Vouhe P, Poulain H, Usdin J P, Aubry P, Vernant P, Galey J J
Arch Mal Coeur Vaiss. 1982 Jun;75(6):725-8.
Commissural disorganisation secondary to incomplete rupture of the ascending aorta was found at surgery for massive aortic incompetence in a young man with previous hypertension. The lesions were repared by a conservative procedure with an excellent result 3 years after surgery. Incomplete spontaneous rupture of the ascending aorta occurs in the same terrain as dissection of the aorta (hypertension, aortic media necrosis) of which it represents a minor form. It may remain asymptomatic but it is usually complicated either by secondary intrapericardial rupture, by aortic aneurysm or by aortic incompetence due to valvular prolapse. When valvular prolapse is associated with another lesion which aggravates the regurgitation (aortic valve disease, aortic ring dilatation) aortic valve replacement should be performed with a prosthesis; on the other hand, when commissural disorganisation giving rise to valvular prolapse is the cause, a conservative procedure may be envisaged.
在一名既往有高血压的年轻男性因严重主动脉瓣关闭不全接受手术时，发现升主动脉不完全破裂继发连合部紊乱。病变通过保守手术修复，术后3年效果良好。升主动脉不完全自发性破裂发生在与主动脉夹层相同的病变区域（高血压、主动脉中层坏死），它是主动脉夹层的一种较轻形式。它可能无症状，但通常会因心包内继发性破裂、主动脉瘤或瓣膜脱垂导致的主动脉瓣关闭不全而复杂化。当瓣膜脱垂与另一个加重反流的病变（主动脉瓣疾病、主动脉环扩张）相关时，应使用人工瓣膜进行主动脉瓣置换；另一方面，当导致瓣膜脱垂的连合部紊乱是病因时，可以考虑采用保守手术。
