An extracardiac unruptured right sinus of valsalva aneurysm complicated with atherothrombosis.
An extracardiac unruptured right sinus of valsalva aneurysm complicated with atherothrombosis.
复制标题
心外未破裂右侧瓦尔萨尔瓦动脉瘤并发动脉粥样硬化一例
DOI：
10.1530/erp-15-0028
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发表时间：
2016-03
影响因子：
6.3
通讯作者：
Deng Y
中科院分区：
文献类型：
--
作者：
Zhang J;Liu Y;Liu L;Deng Y
我们在此报告一罕见的年轻成年男性右心室窦动脉瘤（SVA）合并动脉粥样硬化血栓的病例。我们通过超声心动图诊断了一例35岁男性右冠状动脉窦（RCS）并发心外突出的巨大未破裂SVA。CT增强扫描显示巨大的钙化动脉瘤，伴有起源于主动脉根部的附壁血栓，右冠状动脉起始段狭窄约80%。术中探查发现一个巨大的未破裂的动脉瘤起源于RCS。与之前报道的其他SVAs不同，此动脉瘤壁厚且呈动脉粥样硬化样。动脉瘤局部出现小的内膜撕裂及壁上血栓形成，RCA口几乎被阻塞。该患者接受了外科补片修复以防止动脉瘤破裂和冠状动脉旁路移植术进行RCA血运重建术。总之，病理检查显示动脉瘤壁有明显的泡沫细胞、炎症细胞和血栓形成。valsalva动脉瘤窦的超声心动图特征。心外未破裂SVA的诊断评价。罕见SVA的病理。
We present quite a rare case of extracardiac unruptured right sinus of valsalva aneurysm (SVA) complicated with atherothrombosis in a young adult man. A 35-year-old male with a giant unruptured SVA arising from the right coronary sinus (RCS) with extracardiac protrusion was diagnosed by echocardiography. Contrast-enhanced computed tomography (CT) revealed a huge calcified aneurysm with mural thrombi originating from the aortic root, and about 80% stenosis at the initial segment of the right coronary artery (RCA). Intraoperative exploration demonstrated a giant unruptured aneurysm arising from the RCS. Different from other SVAs reported before, this aneurismal wall appeared thick and atheromatous-like. In this aneurysm, there was a small localized intima tearing and mural thrombosis, and the orifice of the RCA was almost blocked. This patient underwent surgical patch repair to prevent aneurysm rupture and coronary artery bypass grafting for RCA revascularization. In conclusion, the pathological examination demonstrated marked foam cells, inflammatory cells, and thrombosis in the aneurismal wall. Echocardiographic characteristics of sinus of valsalva aneurysm (SVA). Diagnostic evaluation of extracardiac unruptured SVA. Pathology of rare SVA.