TWO-DIMENSIONAL AND DOPPLER ECHOCARDIOGRAPHIC FINDINGS IN A CASE OF SUBAORTIC "FIBROUS SAC"

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概要

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• We described a 37-year-old man with a subaortic "fibrous sac", admitted for congestive heart failure. On 2-dimensional echocardiography a saccular structure was seen to extend from the left coronary cusp of the aortic valve to the outflow tract of the left ventricle. By color Doppler imaging. a grade 3 aortic regurgitation was recognized. Aortic regurgitant flow was recorded from the left coronary cusp to the saccular lesion. When congestive heart failure became exacerbated, the repeat examination showed the regurgitant flow passing through the perforated bottom of this lesion and reaching the left ventricular cavity. On microscopic examination of the excised valve, capillary proliferation and inflammatory changes were recognized near the annular region of the left coronary cusp. The edge of the valve leaflet and the other 2 cusps were intact. It is likely that our patient had a mycotic aneurysm near the aortic ring. We speculate that aortic regurgitation followed inflammation. It dilated the left ventricular cavity and contributed to congestive heart failure. Inflammation also weakened the tissue near the annulus, causing it to protrude into the subaortic region thus forming a small aneurysm. It may have grown to become a large saccular structure under high aortic pressure. That is, it became a "giant endocardial pocket with inflammatory process. Finally, the rupture of this sac caused a massive aortic regurgitation, exacerbating congestive heart failure.

• 社団法人日本循環器学会の論文
• 1991-12-20

著者

• Horio Takeshi

  First Department Of Internal Medicine Osaka City University Medical School

• Akioka Kaname

  First Department of Internal Medicine Osaka City University Medical School

• Toda Iku

  First Department of Internal Medicine Osaka City University Medical School

• Teragaki Masakazu

  First Department of Internal Medicine Osaka City University Medical School

• Takeuchi Kazuhide

  First Department of Internal Medicine Osaka City University Medical School

• Takeuchi Kazuhide

  大阪市立大学 医学研究科循環器病態内科学

• Shimada Ken-ei

  Departments Of Internal Medicine And Cardiology Osaka City University Graduate School Of Medicine

• Takeda Tadanao

  First Department of Internal Medicine, Osaka City University Medical School

• Oku Hisao

  The 1st Department Of Internal Medicine Osaka City University Medical School

• Iida Hidetaka

  First Department Of Internal Medicine Osaka City University Medical School

• Takeda Tadanao

  First Department Of Internal Medicine Osaka City University Medical School

• Takeda Tadanao

  First Department Of Internal Medecine Osaka City University Medical School

• SHOMURA TOYO

  Department of Thoracic and Cardiovascular Surgery, Kobe General Hospital

• Yasuda Mitsutaka

  The 1st Department Of Internal Medicine Osaka City University Medical School

• Tahara Akira

  Osaka City University Medical School

• SHIMADA KEN-EI

  First Department of Internal Medicine, Osaka City University Medical School

• ITAGANE HIROSHI

  First Department of Internal Medicine, Osaka City University Medical School

• TAHARA AKIRA

  First Department of Internal Medicine, Osaka City University Medical School

• YASUDA MITSUTAKA

  First Department of Internal Medicine, Osaka City University Medical School

• OKU HISAO

  First Department of Internal Medicine, Osaka City University Medical School

• SONO JUN

  Department of Thoracic and Cardiovascular Surgery, Kobe General Hospital

• Shomura Toyo

  Department Of Thoracic And Cardiovascular Surgery Kobe General Hospital

• Sono Jun

  Department Of Thoracic And Cardiovascular Surgery Kobe General Hospital

• Shomura Toyo

  Department Of Thoracic And Cardiovascular Surgery Kobe City General Hospital

• Shimada Ken-ei

  First Department Of Internal Medicine Osaka City University Medical School

• Takeda Tadanao

  1st Department Of Internal Medicine Osaka City University Medical School

• Oku Hisao

  First Department Of Internal Medicine Osaka City University Medical School

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