Document Detail


Isolated necrotizing aortitis presenting as incidental thoracoabdominal aortic aneurysm: a case report.
MedLine Citation:
PMID:  22532773     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Noninfectious aortitis is frequently asymptomatic yet often leads to the development of ascending aortic aneurysms requiring repair. We present the case of a 64-year-old Caucasian woman who presented to our medical center with an incidentally discovered thoracoabdominal aneurysm. She had previously been in good health and had not complained of chest pain or been otherwise symptomatic. At presentation to our clinic, her ascending aorta measured 5 cm at the sinotubular junction (STJ) with dilation of her descending thoracic aorta to 6 cm. Her coronary angiogram was normal. Cross-sectional imaging was notable for thickening of the aortic wall along its length. The entity of isolated noninfectious aortitis is increasingly being recognized as an identifiable factor leading to ascending aneurysmal disease. In reviewing this case, we outline current understanding and guidelines for management and follow-up of this pathology. Operative repair of the ascending arch was conducted using an interpositional graft. The aortic valve apparatus was normal and the proximal anastomosis was created at the STJ. Intraoperatively, an inflammatory obliteration of the aortopulmonary window was noted. It was not possible to completely excise the posterior aortic wall. Our patient had an uneventful recovery and final pathology revealed necrotizing aortitis (NA). She is currently undergoing routine surveillance of her descending thoracoabdominal aneurysm. Recent case series indicate that NA is a histologically distinct process, which is associated commonly with development of ascending aneurysm, and although it is most commonly an isolated finding, it may be associated with other vascular abnormalities including stenoses of branch vessels. There is a growing body of literature suggesting that NA represents a distinct clinical entity, associated with the development of ascending aortic aneurysms. Further research is required to determine the optimal follow-up and value of medical therapies.
Authors:
Jeremiah T Martin; William N O'Connor; Chandrashekar Ramaiah
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The International journal of angiology : official publication of the International College of Angiology, Inc     Volume:  20     ISSN:  1615-5939     ISO Abbreviation:  Int. J. Angiol.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2012-04-25     Completed Date:  2012-08-23     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  9504821     Medline TA:  Int J Angiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  59-62     Citation Subset:  -    
Affiliation:
University of Kentucky Medical Center, Lexington, Kentucky.
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