主动脉根假性动脉瘤1例报告及文献复习

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Pravinthiran Manokaran, Sivakumar Krishnasamy, Raja Rizal Azman Bin Raja Aman, Victoria Wen Yeng Teoh, Alexander Loch
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引用次数: 0

摘要

主动脉根部的假性动脉瘤非常罕见。本文描述了一例人工主动脉瓣感染病例,该病例从局限性硬膜内脓肿发展为与主动脉相通的破裂脓肿,并形成了一个巨大的假性动脉瘤。此外,还分析了 2000 年至 2021 年间发表的所有病例和系列病例的数据。以 "主动脉根部霉菌性动脉瘤"、"主动脉根部脓肿和感染性心内膜炎"、"主动脉根部霉菌性动脉瘤和感染性心内膜炎 "为关键词进行PUBMED检索,共获得152篇文献(其中描述了157个病例):主动脉假性动脉瘤多见于男性(80.9%,n = 127)。平均年龄为 51 岁(4 个月-84 岁)。最常见的症状是发烧(68.5%,n = 102)。确诊前的平均时间为 27.2 天。诊断时出现栓塞并发症的比例为 17.8%(n = 28)。大多数病例由瓣膜感染引起(72 例,45.9%)。49.0%的病例(77 例)曾接受过心脏手术。心脏手术后患主动脉根部脓肿的平均时间间隔为 32.2 个月。22.3%(n = 35)的患者免疫力低下。病原体为葡萄球菌(34.1%,n = 47)和链球菌(23.2%,n = 32)。平均抗菌治疗时间为 58.5 天。手术治疗效果优于药物治疗:住院病人总死亡率为 18.5%(n = 27);手术治疗为 12.2%(123 例患者中的 15 例),药物治疗为 47.8%(23 例患者中的 11 例)。总之,主动脉根部假性动脉瘤最常见于中年男性患者。既往主动脉手术史也很常见。正确的诊断取决于详细的病史、经食道超声心动图和主动脉计算机断层扫描(CT)。手术是首选治疗方案:在线版本包含补充材料,可在 10.1007/s12055-023-01580-x.上查阅。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Aortic root pseudoaneurysm: a case report and literature review.

Pseudoaneurysms of the aortic root are rare. A case of prosthetic aortic valve infection progressing from a confined intramural abscess to a ruptured abscess communicating with the aorta and forming a large pseudoaneurysm is described. Additionally, data from all cases and case series, published between 2000 and 2021, was analyzed. A PUBMED search for the keywords "aortic root mycotic aneurysm," "aortic root abscess AND infective endocarditis," and "aortic root mycotic aneurysm AND infective endocarditis" yielded 152 publications (with 157 cases described): Aortic pseudoaneurysm is more common in males (80.9%, n = 127). Mean age is 51 years (4 months-84 years). The most common symptom is fever (68.5%, n = 102). Mean time until diagnosis is 27.2 days. Embolic complications are present in 17.8% (n = 28) at diagnosis. Most cases are due to valvular infections (n = 72 cases, 45.9%). Prior cardiac surgery is documented in 49.0% (n = 77). The mean time interval for developing aortic root abscess following heart surgery is 32.2 months. 22.3% (n = 35) are immunocompromised. Aetiological agents were Staphylococcus sp. (34.1%, n = 47) and Streptococcus sp. (23.2%, n = 32). Mean antimicrobial therapy lasts 58.5 days. Outcome with surgery is superior to medical treatment: overall inpatient mortality 18.5% (n = 27); with surgery 12.2% (n = 15 out of 123 patients), with only medical management 47.8% (n = 11 out of 23 patients). In conclusion, aortic root pseudoaneurysm occurs most commonly in middle-aged male patients. History of prior aortic procedures is commonly present. Correct diagnosis hinges on detailed history, transoesophageal echocardiography, and computed tomography (CT) aorta. Surgery is the preferred therapeutic option.

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-023-01580-x.

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来源期刊
Indian Journal of Thoracic and Cardiovascular Surgery
Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.20
自引率
14.30%
发文量
141
期刊介绍: The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.
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