11/66. Aortic root replacement for prosthetic aortic valve detachment without regurgitation and with enlarged Valsalva's sinuses and complete atrioventricular block caused by Takayasu's aortitis.We replaced the aortic root in a 43-year-old woman with Takayasu's aortitis associated with prosthetic aortic valve detachment. The patient's aortic valve had been replaced when she was 31 years old with a mechanical prosthesis to treat aortic regurgitation. Though c-reactive protein was kept almost normal with prednisolone, complete atrioventricular block suddenly appeared 12 years after the first operation. After the implantation of an artificial pacemaker, we closely followed up aortic root status. aortography and echocardiography showed that the valve moved up and down, probably due to enlargement of the sinuses of Valsalva, without perivalvular leakage. We removed the prosthetic aortic valve, which was partially detached from the aortic valve ring at the right- and non-coronary cusps and successfully replaced the aortic root with a mechanical prosthesis inserted into a 26 mm woven graft. Although the postoperative course was uneventful, we closely continue to observe the case and to administer of antiinflammatory medication.- - - - - - - - - - ranking = 1keywords = aortitis (Clic here for more details about this article) |
12/66. Progression of Takayasu's aortitis in a young Japanese woman: serial angiographic study.Progression of Takayasu's aortitis was observed by serial angiography over 2 years. Acute aortic regurgitation due to marked dilatation of the proximal ascending aorta was followed by aneurysmal dilatation of the distal ascending aorta. Aneurysmal dilatation of the carotid arteries then developed, with subsequent obstruction of both the bilateral vessels by thrombosis.- - - - - - - - - - ranking = 1keywords = aortitis (Clic here for more details about this article) |
13/66. Abdominal aortic dissection due to idiopathic medial aortopathy in a 32-year-old Caucasian man.A case of dissection of the abdominal aorta in a 32-year-old Caucasian man associated with a histological diagnosis of granulomatous aortitis and a clinical diagnosis of idiopathic medial aortopathy is described. The relationship between giant cell "temporal" arteritis, Takayasu's disease and idiopathic medial aortopathy is discussed.- - - - - - - - - - ranking = 0.2keywords = aortitis (Clic here for more details about this article) |
14/66. Initial appearance of an ill-defined shadow on a chest roentgenogram in a patient with aortitis syndrome.A 20-years-old woman with fever and an abnormal shadow on a chest roentgenogram was admitted to our hospital. High grade fever continued even after gradual disappearance of the ill-defined shadow on the right upper lobe (S3) with minor fissure deviation upward, while neck pain and bruit gradually developed. She was diagnosed as aortitis syndrome from a digital subtraction angiography. The initial appearance of an ill-defined shadow on a chest roentgenogram, considered as pulmonary infarction, is rare in the aortitis syndrome and this kind of onset is interesting in relation to the pathogenesis and diagnosis of this syndrome.- - - - - - - - - - ranking = 1.2keywords = aortitis (Clic here for more details about this article) |
15/66. An orange-shaped aortic root aneurysm in aortitis syndrome with severe aortic regurgitation.A 57-year-old man, who had undergone aorto-coronary bypass surgery 4 years before when the shape of the ascending aorta had been normal, had a unique orange-shaped aortic root aneurysm associated with severe aortic regurgitation and congestive heart failure. Replacement of the aneurysm and the aortic valve was successfully carried out, and histopathological examination revealed that the aneurysm was caused by aortitis syndrome.- - - - - - - - - - ranking = 1keywords = aortitis (Clic here for more details about this article) |
16/66. Large vessel involvement in ANCA-associated vasculitides: report of a case and review of the literature.Vasculitides are currently classified according to the size of the vessels involved and characteristic clinical and histopathologic findings. Antineutrophil cytoplasmic antibodies (ANCA) and other serologic tests have been used to further characterize small vessel vasculitides. Large vessel involvement in ANCA-associated small vessel vasculitides has been overlooked in the medical literature. Here, we report a case of fatal aortitis and aortic dissection in a patient with microscopic polyangiitis and review reported cases of large vessel involvement in ANCA-associated vasculitides since 1990. We have attempted to characterize this subgroup of patients. Large vessel disease in ANCA-associated vasculitis may present as stenosing large vessel arteritis, aneurysmal disease, aortic dissection, aortic rupture, aortic regurgitation, and death. Prominent perivascular inflammation may present as mediastinal, cervical or abdominal soft tissue masses. ANCA-associated large vessel disease should be considered in the differential diagnosis of these disorders. The epidemiologic, clinical and pathologic characteristics of these patients differ from those of the well-defined large vessel vasculitides such as giant cell (temporal) arteritis or Takayasu's arteritis. We suggest that large vessel involvement is part of the spectrum of ANCA-associated vasculitis rather than an overlap with other large vessel vasculitides. It occurs in both myeloperoxidase- and proteinase 3-positive patients with either Wegener's granulomatosis or microscopic polyangiitis, but has not been reported in churg-strauss syndrome. Large vessel vasculitis can precede small vessel vasculitis or occur in the absence of small vessel involvement. We hope this report will contribute to the ongoing development of classification systems for the vasculitic syndromes.- - - - - - - - - - ranking = 0.2keywords = aortitis (Clic here for more details about this article) |
17/66. aortic valve regurgitation due to cusp aneurysm: a case report.Two-dimensional echocardiography is a valuable tool in visualizing and monitoring aortic valve and root abnormalities. We present a rare case of a patient with massive aortic regurgitation due to cusp aneurysm, which was accurately diagnosed by echocardiography and treated by valve replacement. A complicated course with recurrent aneurysms of the aortic wall after aortic valve replacement was remarkable in this case. Although different possible etiologies could not be determined, endocarditis and/or aortitis may be the most likely explanation of the complicated and finally fatal course of this patient.- - - - - - - - - - ranking = 0.2keywords = aortitis (Clic here for more details about this article) |
18/66. Accelerated atherosclerosis, aneurysmal disease, and aortitis: possible pathogenetic association with cocaine abuse.cocaine abuse and its association with vascular disease has become common in the medical literature. A variety of vascular problems have been described including neurovascular complications, cardiovascular complications, aortic dissection, venous thrombosis, mesenteric artery thrombosis, and renal infarction. The pathogenesis of these vascular complications has largely been related to increased adrenergic activity leading to vasospasm. Interaction of cocaine with the vascular endothelium resulting in thrombosis or vasculitis has also been suggested. We report a case of diffuse aneurysmal change of the aorta associated with an atypical inflammatory component consistent with possible cocaine induced vasculitis.- - - - - - - - - - ranking = 0.8keywords = aortitis (Clic here for more details about this article) |
19/66. Aortic root replacement with a freestyle stentless valve for aortitis syndrome with ascending aortic aneurysm and aortic regurgitation.A 47-year-old woman who had been diagnosed as having aortitis syndrome underwent aortic root replacement for an ascending aortic aneurysm and aortic regurgitation. Because the patient has been treated with steroids for more than 20 years, a Freestyle stentless valve was used to avoid the risk of valve detachment. There were no complications observed during the postoperative course. Although long-term follow-up will be necessary to observe the valve durability, the Freestyle stentless valve seems to be useful for aortic root replacement in patients at high risk of valve detachment due to aortitis syndrome.- - - - - - - - - - ranking = 1.2keywords = aortitis (Clic here for more details about this article) |
20/66. Evolving infectious aortitis caused by streptococcus pneumoniae.Infections of major vessels leading to mycotic aneurysms can be a diagnostic dilemma for clinicians, and can be accompanied by a high mortality rate. Successful treatment of this condition often requires a high index of suspicion and prompt medical and surgical attention. The authors report two cases of infectious aortitis caused by pneumococcus that evolved during hospitalization, and discuss diagnostic difficulties that accompany this entity.- - - - - - - - - - ranking = 1keywords = aortitis (Clic here for more details about this article) |
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