Yamauchi M, Eishi K, Sasako K, Nakano K, Isobe F, Kosakai Y, Kito Y, Kawashima Y
First Department of Surgery, Shimane Medical University, Izumo, Japan.
Kyobu Geka. 1994 Dec;47(13):1083-5.
A 40-year-old man had received emergency Bentall's operation due to acute aortic regurgitation (AR) of aortitis in October, 24, 1990. On out patient clinic, the CRP had been kept from 0.5 to 1.5 mg/dl in dose of 10 mg of prednisolone. In the midnight of November, 17, 1992, his condition deteriorated to circulatory shock and echocardiography revealed massive AR due to para-annular graft detachment with large pseudoaneurysm of 50 mm. He was transferred for emergency operation. The composite graft shifted 2-3 cm above the annulus and detached in three quarter of the annulus. Distal anastomosis was also detached in half of anastomosis and coronary anastomosis almost detached. He was operated on modified Bentall's operation employing Piehler's technique and he is now followed in dose of 10 mg of prednisolone. There are some cases of aortitis showing recurrent valve or graft detachment like this case, even if modified Bentall's operation have been done to decrease the mechanical stress to the annulus and the inflammation have been controlled under the dosage of steroid.
一名40岁男性于1990年10月24日因主动脉炎导致急性主动脉反流（AR）接受了紧急Bentall手术。在门诊，服用10毫克泼尼松龙时，CRP一直维持在0.5至1.5毫克/分升。1992年11月17日午夜，他的病情恶化为循环性休克，超声心动图显示由于瓣环旁移植物 detachment 伴50毫米大的假性动脉瘤导致大量AR。他被转至急诊手术。复合移植物在瓣环上方移位2 - 3厘米，瓣环四分之三处 detachment。远端吻合口也有一半 detachment，冠状动脉吻合口几乎 detachment。他接受了采用Piehler技术的改良Bentall手术，目前服用10毫克泼尼松龙进行随访。有一些主动脉炎病例，如本病例所示，即使已经进行了改良Bentall手术以降低瓣环的机械应力，且炎症在类固醇剂量控制下，仍会出现瓣膜或移植物反复 detachment 的情况。 （注：原文中“detachment”未明确准确意思，可能是“脱离”等，此处保留英文未翻译）
