Valve-Sparing Root Replacement for Syphilitic Aortic Arch Aneurysm with Aortic Regurgitation

Yujiro Kawai	Mitsutaka Nakao	Hirokazu Niitsu
Yasuyuki Toyoda	Yasutoshi Tsuda	Kazuaki Shiratori
Takahiro Takemura

（Department of Cardiovascular Surgery, Advanced Care Center, Saku Central Hospital, Saku, Japan）

Syphilitic aortic aneurysm became rare after the discovery of penicillin. Syphilitic aortitis involves the ascending aorta and dilates the aortic annulus, causing aortic valve regurgitation. We report a case of syphilitic aortic aneurysm with severe aortic valve regurgitation, which was successfully treated with the replacement of the valve-sparing root and the total arch. A 55-year-old man, admitted earlier to another hospital for colon diverticulum, was found to have an aortic arch aneurysm. Enhanced computed tomography revealed the aneurysm of the ascending aorta to the transverse arch aorta with the maximum short diameter of the aneurysm at 68mm. He also had a saccular aneurysm in the ascending aorta. Although he had never had a history of syphilis, a routine laboratory test for syphilis was positive. That said, we looked upon this case as a syphilitic aortic aneurysm. In preoperative cardiac echography, the aortic regurgitation was severe with mild valve stenosis and mainly due to dilation of the aortic root. We thought the native valve could be spared and replaced both the valve-sparing root and the total arch. He was discharged on the 11th postoperative day without any complications.

 

Jpn. J. Cardiovasc. Surg. 44:271-274（2015）

Keywords：syphilitic aortic aneurysm;aortic regurgitation;valve-sparing root replacement