Aortitis as a Rare Cause of Aortic Aneurysm and Valve Regurgitation: Is Repair Precluded?
Carlos Porras, Gemma Sanchez-Espin, Miguel Such, Jesús Sánchez-Ramos, Alicia Bautista-Pavés, Pilar Martín-de la Fuente, Josefa Ruiz, Norberto Ortego-Centeno, Isabel Rodríguez-Bailón, and José María Melero
Case Reports in Cardiology 2018
DOI: 10.1155/2018/5757081
Resumen del artículo:
La aortitis (inflamación de la aorta) es una causa poco frecuente de aneurisma de la raíz de la aorta y de regurgitación aórtica. No hay pruebas claras de cual es el tratamiento de elección ni de si es aconsejable o no la cirugía reparadora de la válvula aórtica en estos casos.
Presentamos el caso de una mujer de 38 años de edad, embarazada, con diagnóstico de aortitis de origen desconocido asociado a aneurisma de raíz de aorta y regurgitación aórtica severa.
INTRODUCTION
Aortitis is an infrequent cause of aortic root dilatation and aortic valve regurgitation, having been described several infectious and noninfectious etiologies for this yet not well-known entity [1]. The approach to the “valvular problem” is controversial, having been reported increased rates of paravalvular leaks with prosthetic replacement [2]. Valve-sparing procedures have also been proposed [3], but there is not clear evidence of which is the treatment of choice.
CASE PRESENTATION
We report the case of a 38-year-old pregnant lady with a diagnosis of idiopathic aortitis associated with aortic root aneurysm and severe aortic valve regurgitation.
The patient had a history of cardiac murmur, having had an echocardiogram performed two years before the episode showing a mild mitral regurgitation with a normal aortic valve and aorta. She was asymptomatic until the 4th month of pregnancy when she began with tachycardia and exertional dyspnea which rapidly evolved to rest dyspnea; she was admitted to the hospital, and an echocardiographic study was performed, showing a very severe aortic regurgitation and a 5.5 cm aneurysm of the root and ascending aorta; the left ventricle was markedly dilated with a borderline ventricular fraction. No computed tomography scan was done to avoid potential damage to the fetus.
She was transferred to our unit for urgent surgery for a planned valve-preserving surgery.
…
The postoperative course of the patient was uneventful. She was discharged on metoprolol and iron. A transthoracic echocardiogram was performed before discharge showing a mild regurgitation of the aortic valve with a marked unloading of the left ventricle.
She continued her pregnancy, and a healthy girl was born with a vaginal delivery.
…
Puede acceder al artículo completo (en inglés) en este enlace:
Aortitis as a Rare Cause of Aortic Aneurysm and Valve Regurgitation: Is Repair Precluded?
