From Wikipedia, the free encyclopedia
Medical condition
Annuloaortic ectasia is characterized by pure
aortic valve regurgitation and aneurysmal dilatation of the
ascending aorta .
[2] Men are more likely than women to develop idiopathic annuloaortic ectasia, which usually manifests in the fourth or sixth decades of life. Additional factors that contribute to this condition include
osteogenesis imperfecta , inflammatory aortic diseases, intrinsic valve disease,
Loeys-Dietz syndrome ,
Marfan syndrome , and operated
congenital heart disease .
[3]
On a gross level, there is a pear-shaped, symmetric enlargement due to proximal aortic dilation. The aortic wall dilatation at the commissural level causes the
cusps to effectively shorten and prevent them from converging during
systole , which results in
aortic valve incompetence. The arch is typically spared from the aneurysmal process, though it may involve the entire ascending aorta. The ectatic aorta may experience dissections. Dissections of the ascending aorta are typically tiny, confined, and restricted. Aortic rupture can happen even if there is no dissection.
[3]
The term was first coined by the American heart surgeon
Denton Cooley in 1961.
[4]
Signs and symptoms
Symptoms are often neurological or circulatory.
[5] Symptoms include
dyspnea ,
respiratory distress ,
heart failure ,
atrial tachycardia ,
[6] pain,
cardiac tamponade ,
[7]
palpitations , and
malaise .
[8]
Aortic valve regurgitation is found in about 77% of all patients.
[9]
Treatment
For many years, the gold standard treatment for patients with aortic valve disease and aortic root aneurysms was to replace both the
aortic valve and the
ascending aorta with a composite graft. This also applies to patients with different levels of AI and annuloaortic ectasia, where the aortic valve may be largely preserved without any structural abnormalities.
[10]
See also
References
^
"Orphanet: Familial aortic dissection" . Orpha.net . Retrieved 29 May 2019 .
^ An, Zhao; Xu, Zhi-Yun; Poullis, Mike; Tang, Paul C.; Oliveira, Nilto De; Rylski, Bartosz; Milewski, Rita K.; Urbanski, Paul P.; Diegeler, Anno; Kumar, Neeraj; Yang, Laurence T. (December 1, 2004).
"Aortic valve sparing operations: basic concepts" . International Journal of Cardiology . 97 . Elsevier: 61–66.
doi :
10.1016/j.ijcard.2004.08.010 .
ISSN
0167-5273 .
PMID
15590080 . Retrieved December 29, 2023 .
^
a
b Kinoshita, Ryoji; Arai, Hirokuni; Barillà, David; Benedetto, Filippo; Ladich, E.; Virmani, R.; Seidman, M.A.; McManus, B.M.; Subbotin, Vladimir M.; Spanos, K.; Giannoukas, A.D. (January 1, 2016).
Vascular Pathobiology: Atherosclerosis and Large Vessel Disease . Academic Press. pp. 85–124.
doi :
10.1016/B978-0-12-420219-1.00003-3 .
ISBN
9780124202191 . Retrieved December 29, 2023 .
^ Kaiser, Larry; Kron, Irving L.; Spray, Thomas L. (2013-12-24).
Mastery of Cardiothoracic Surgery . Lippincott Williams & Wilkins.
ISBN
9781451113150 .
^ S, Gelsomino; S, Romagnoli; F, Gori; G, Nesi; C, Anichini; C, Sorbara; P, Stefàno; GF, Gensini (2005).
"Annuloaortic ectasia and giant cell arteritis" . The Annals of Thoracic Surgery . 80 (1). Ann Thorac Surg: 101–105.
doi :
10.1016/j.athoracsur.2005.01.063 .
ISSN
1552-6259 .
PMID
15975349 . Retrieved December 29, 2023 .
^ G, Nesi; C, Anichini; E, Pedemonte; S, Tozzini; G, Calamai; GF, Montesi; F, Gori (2002).
"Giant cell arteritis presenting with annuloaortic ectasia" . Chest . 121 (4): 1365–1367.
doi :
10.1378/chest.121.4.1365 .
ISSN
0012-3692 .
PMID
11948080 . Retrieved December 29, 2023 .
^ T, Fujii; S, Sumiyoshi; T, Koga; M, Nishizaka; R, Matsukawa; H, Kuwano; K, Sueishi (2007).
"An autopsy case report of annuloaortic ectasia with cardiac tamponade ruptured from an aneurysm of the right Valsalva sinus" . Pathology, Research and Practice . 203 (9). Pathol Res Pract: 671–675.
doi :
10.1016/j.prp.2007.05.007 .
ISSN
0344-0338 .
PMID
17646055 . Retrieved December 29, 2023 .
^ H, Harada; Y, Honma; Y, Hachiro; T, Mawatari; T, Abe (2002).
"Composite graft replacement after aortic valvuloplasty in Takayasu arteritis" . The Annals of Thoracic Surgery . 73 (2). Ann Thorac Surg: 644–647.
doi :
10.1016/s0003-4975(01)03363-x .
ISSN
0003-4975 .
PMID
11845892 . Retrieved December 29, 2023 .
^ Yuan, Shi-Min; Lin, Hong (2019).
"Annuloaortic Ectasia and Arteritis: Clinical Features, Treatments of Choice, and Causative Relations" . Brazilian Journal of Cardiovascular Surgery . 34 (4). Sociedade Brasileira de Cirurgia Cardiovascular: 472–479.
doi :
10.21470/1678-9741-2018-0252 .
PMC
6713369 .
PMID
31454202 .
^ Martino, Andrea De; Re, Federico Del; Blasi, Stefania; Celiento, Michele; Ravenni, Giacomo; Pratali, Stefano; Milano, Aldo D.; Bortolotti, Uberto (2017).
"Surgical Treatment of Annuloaortic Ectasia – Replace or Repair?" . AORTA Journal . 5 (5). Thieme Medical Publishers: 139–147.
doi :
10.12945/j.aorta.2017.17.044 .
PMC
5890764 .
PMID
29657952 .
Further reading
Mestres, Gaspar; Riambau, Vincent; Seidman, M.A.; McManus, B.M.; Misra, Durga Prasanna; Negi, Vir Singh; Sato, Hiroshi; Tamiya, Yukihiko; Fishbein, G.A.; Buja, L.M.; Schoen, F.J.; Butany, J. (January 1, 2016).
Aneurysms of the Aorta: Ascending, Thoracic and Abdominal and Their Management . Academic Press. pp. 169–211.
doi :
10.1016/B978-0-12-420219-1.00005-7 .
ISBN
9780124202191 . Retrieved December 29, 2023 .
Cooley, Denton A. (1985). "Annuloaortic Ectasia: Surgical Repair Using a Composite ST. JUDE MEDICAL® Valve and DACRON® Tube Graft". Cardiac Valve Replacement . Boston, MA: Springer US. pp. 73–81.
doi :
10.1007/978-1-4613-2601-4_10 .
ISBN
978-1-4612-9629-4 .
External links
Classification External resources