Aortic dissection extending into the interventricular septum following redo aortic valve replacement surgery in a patient with Takayasu's arteritis: a rare case report.

Pub Date : 2024-09-10 eCollection Date: 2024-09-01 DOI:10.1093/ehjcr/ytae496
Chan-Han Hu, Chun-Hao Chang, Meng-Ta Tsai, Wei-Chuan Tsai, Mu-Shiang Huang
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Abstract

Background: Takayasu's arteritis is an infrequent manifestation of vasculitis affecting the aorta and its primary branches with numerous symptoms. This report details a rare case wherein a patient developed interventricular septal dissection following aortic valve replacement.

Case summary: A middle-aged woman diagnosed with Takayasu's arteritis previously underwent aortic valve replacement with a mechanical valve owing to severe aortic regurgitation. Subsequently, she received a redo aortic valve replacement following an episode of prosthetic valve infective endocarditis with paravalvular leak. Heart failure symptoms emerged during follow-up, revealing aortic root dissection extending into the interventricular septum, causing significant prosthetic valve movement. A Trido Bentall operation and interventricular septum repair were performed, and the patient recovered smoothly.

Discussion: Interventricular dissection, although uncommon, may be due to factors such as infection, myocardial infarction, congenital anomalies, trauma, or post-surgical shear stress. Timely diagnosis is imperative to prevent life-threatening complications; surgery remains the primary treatment. The present case report describes a rare presentation that was successfully managed through a Bentall operation and underscores the necessity of prompt intervention in treating this condition.

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一名高安动脉炎患者在重做主动脉瓣置换手术后主动脉夹层延伸至室间隔:罕见病例报告。
背景:高安动脉炎是一种不常见的血管炎表现,会影响主动脉及其主要分支,并伴有多种症状。本报告详细介绍了一例罕见病例,患者在主动脉瓣置换术后发生室间隔夹层。病例摘要:一名被诊断患有高安市动脉炎的中年女性曾因主动脉瓣严重反流而接受过主动脉瓣置换术,置换的是一个机械瓣。随后,她因人工瓣膜感染性心内膜炎并伴有瓣膜旁漏而接受了主动脉瓣置换术。随访期间出现了心衰症状,发现主动脉根部夹层延伸至室间隔,导致人工瓣膜明显移动。经过特里多-本托尔手术和室间隔修补术,患者顺利康复:讨论:室间隔夹层虽然并不常见,但可能由感染、心肌梗死、先天性异常、外伤或手术后剪切应力等因素引起。及时诊断是防止危及生命的并发症的当务之急;手术仍是主要的治疗方法。本病例报告描述了一个罕见的病例,该病例通过 Bentall 手术成功治愈,并强调了及时干预治疗这种疾病的必要性。
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