Tomita M, Shimokawa I, Ikeda T, Iwasaki K, Higami Y, Ohtani H, Matsushita T, Fukui J, Shikuwa M
Department of Pathology, Nagasaki University, School of Medicine, Japan.
Pathol Int. 1996 Sep;46(9):667-72. doi: 10.1111/j.1440-1827.1996.tb03670.x.
Two autopsy cases with pericardial tamponade and spontaneous rupture of non-aneurysmal ascending aorta are described. In case 1, no apparent predisposing factor was clinically noticed in a 74 year old male patient, but postmortem examination revealed laceration of the ascending aorta associated with aortic valvular deformity and slight dilatation of the ascending aorta. In case 2, a 61 year old man, a mild to moderate grade of aortic regurgitation was noticed clinically 5 months before death. Postmortem examination revealed a slight dilatation of the aortic annulus and post-valvular portion of the ascending aorta. These two cases emphasize the clinical significance of aortic valvular disease with subsequent disordered blood flow, even when asymptomatic, as a potential causative factor for spontaneous rupture of the ascending aorta.
本文描述了两例心包填塞伴非动脉瘤性升主动脉自发破裂的尸检病例。病例1中,一名74岁男性患者临床上未发现明显的诱发因素,但尸检显示升主动脉撕裂,伴有主动脉瓣畸形和升主动脉轻度扩张。病例2中,一名61岁男性,在死亡前5个月临床上发现轻度至中度主动脉瓣反流。尸检显示主动脉瓣环和升主动脉瓣后部分轻度扩张。这两个病例强调了即使无症状,主动脉瓣疾病伴随后的血流紊乱作为升主动脉自发破裂潜在病因的临床意义。