Masaki H, Inada H, Morita I, Fukuhiro Y, Tabuchi A, Fujiwara T
Department of Thoracic and Cardiovascular Surgery, Kawasaki Medical School, Okayama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Apr;45(4):655-60.
Ruptured fusiform descending thoracic aortic aneurysms due to aortitis syndrome are rare. A 29-year-old woman was readmitted to our hospital with a chief complaint of back pain and shock, and diagnosed as having rupture of a descending thoracic aortic aneurysm. She had a past history of aortitis syndrome beginning eight years ago. On chest CT examination earlier a year, the descending thoracic aortic aneurysm was 4.5 cm in diameter, and calcification we observed in the aortic wall. An inflammatory reaction had been controlled by steroid therapy and her blood pressure had been controlled by vasodilator drugs. Emergent graft replacement of a descending aortic aneurysm was successfully performed under a femoro-femoral bypass using a centrifugal pump and membrane oxygenerator, and Cell Sver. Although in the literature surgical treatment is indicated only if there is a symptomatic or enlarging aneurysm especially of saccular type and no operation is justified for an aortic aneurysm showing marked calcification, we concluded that aggressive surgical treatment was necessary for this fusiform aneurysm due to aortitis syndrome.
大动脉炎综合征所致梭形降主动脉瘤破裂罕见。一名29岁女性因背痛和休克为主诉再次入院，诊断为降主动脉瘤破裂。她有大动脉炎综合征病史，始于8年前。在一年前的胸部CT检查中，降主动脉瘤直径为4.5 cm，且在主动脉壁观察到钙化。炎症反应已通过类固醇治疗得到控制，血压已通过血管扩张剂药物得到控制。在使用离心泵、膜式氧合器和Cell Sver进行股-股旁路的情况下，成功地对降主动脉瘤进行了急诊移植物置换。尽管文献表明，仅当存在有症状或增大的动脉瘤，尤其是囊状动脉瘤时才进行手术治疗，而对于显示明显钙化的主动脉瘤，手术治疗并不合理，但我们得出结论，对于这种因大动脉炎综合征导致的梭形动脉瘤，积极的手术治疗是必要的。
