Annuloaortic ectasia and giant cell arteritis

被引:23
作者
Gelsomino, S
Romagnoli, S
Gori, F
Nesi, G
Anichini, C
Sorbara, C
Stefàno, P
Gensini, GF
机构
[1] Careggi Hosp, Cardiac Surg Unit, Dept Cardiac Surg, I-50134 Florence, Italy
[2] Careggi Hosp, Cardiac Surg Unit, Dept Anesthesia, I-50134 Florence, Italy
[3] Univ Florence, Dept Pathol, Florence, Italy
[4] Univ Florence, Dept Clin Med, Florence, Italy
[5] Univ Florence, Dept Cardiol, Florence, Italy
关键词
D O I
10.1016/j.athoracsur.2005.01.063
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Thoracic aortic aneurysm, aortic dissection and aortic valve regurgitation have been widely described in patients with Horton disease, also known as giant cell arteritis. We present our midterm experience with patients with these features. Methods. A total of 386 cases of ascending aorta and aortic valve replacement performed for thoracic aortic aneurysm and aortic insufficiency between 1998 and 2004 were reviewed. Among them 10 cases of histopathologically confirmed GAA were identified. Patients were predominantly female (90%); the mean age was 74.5 +/- 4.6 years. Results. Eight patients (80%) showed typical annuloaortic ectasia, leading to significant aortic valve regurgitation. These subjects underwent a Bentall operation. Two patients whose sinuses seemed undilated and macroscopically normal had separate valve graft replacement at first operation and underwent reoperation due to dilatation of the native sinuses. Eight patients had partial aortic arch replacement (hemiarch), and I underwent total arch replacement. Six-year survival was 0.9 +/- 0.09; freedom from reoperation at 6 years was 0.77 +/- 0.13. Conclusions. Annuloaortic ectasia is a common finding in giant cell arteritis. In patients with Horton disease, the aortic root should always be replaced regardless of macroscopic findings. (c) 2005 by The Society of Thoracic Surgeons.
引用
收藏
页码:101 / 105
页数:5
相关论文
共 36 条
[21]   AORTIC AND EXTRACRANIAL LARGE VESSEL GIANT-CELL ARTERITIS - A REVIEW OF 72 CASES WITH HISTOPATHOLOGIC DOCUMENTATION [J].
LIE, JT .
SEMINARS IN ARTHRITIS AND RHEUMATISM, 1995, 24 (06) :422-431
[22]   AORTIC DISSECTION IN GIANT-CELL ARTERITIS [J].
LIU, G ;
SHUPAK, R ;
CHIU, BKY .
SEMINARS IN ARTHRITIS AND RHEUMATISM, 1995, 25 (03) :160-171
[23]   Giant cell arteritis presenting with annuloaortic ectasia [J].
Nesi, G ;
Anichini, C ;
Pedemonte, E ;
Tozzini, S ;
Calamai, G ;
Montesi, GF ;
Gori, F .
CHEST, 2002, 121 (04) :1365-1367
[24]  
Nir-Paz R, 2002, J RHEUMATOL, V29, P1219
[25]  
Nordborg E, 2000, CLIN EXP RHEUMATOL, V18, pS15
[26]   Mortality of large-artery complication (Aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis - A population-based study over 50 years [J].
Nuenninghoff, DM ;
Hunder, GG ;
Christianson, TJH ;
McClelland, RL ;
Matteson, EL .
ARTHRITIS AND RHEUMATISM, 2003, 48 (12) :3532-3537
[27]   Incidence and predictors of large-artery complication (aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis - A population-based study over 50 years [J].
Nuenninghoff, DM ;
Hunder, GG ;
Christianson, TJH ;
McClelland, RL ;
Matteson, EL .
ARTHRITIS AND RHEUMATISM, 2003, 48 (12) :3522-3531
[28]   Concomitant giant cell aortitis, thoracic aortic aneurysm, and aortic Arch syndrome: Occurrence in a patient and significance [J].
Nuenninghoff, DM ;
Warrington, KJ ;
Matteson, EL .
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH, 2003, 49 (06) :858-861
[29]  
Nuenninghoff DM, 2003, J RHEUMATOL, V30, P1119
[30]   Survival after aortic dissection in giant cell arteritis [J].
Richardson, MP ;
Lever, AML ;
Fink, AM ;
Dixon, AK ;
Hazleman, BL .
ANNALS OF THE RHEUMATIC DISEASES, 1996, 55 (05) :332-333