Only 2 comprehensive surgical series, published in 1977 and 1983, have evaluated clinicopathologic features of the ascending aorta. Retrospective review of medical records and microscopic slides was performed on 513 consecutive patients with surgical resection of ascending aortic tissue (1985 to 1999). Patients were 2 to 89 years old (mean 59 y), and 303 (59%) were men. Aneurysm or dissection was the indication for surgery in 479. Aortic valves were also excised in 360. Systemic hypertension was present in 279, inherited connective tissue disease (ICTD) in 67, arteritis in 33, and acquired connective tissue disease in 16. Microscopy showed cystic medial degeneration (CMD) in 209, aortic dissection (AD) in 109 (with CMD in 56), normal media in 90, aortitis in 57 (with CMD in 14), and other findings in 48. The most significant, independent risk factor of CMD and AD was ICTD (confidence interval=7.61 and 2.26, respectively). Systemic hypertension was more common in patients with AD than without (P=0.0202). Normal media was the most common histologic finding associated with bicuspid aortic valve (P<0.0001). Among 57 patients with aortitis (giant cell in 39), ages ranged from 16 to 85 years (mean 64 y), and 42 (74%) were women; only 8 had Takayasu arteritis, and 11 had temporal or systemic arteritis. In surgically resected ascending aorta, the 3 most common histologic findings were CMD, AD, and normal media. ICTD, systemic hypertension, and bicuspid aortic valve were common comorbid findings. Giant cell aortitis occured predominantly in women, usually without systemic disease.

译文

:仅在1977年和1983年出版的2个综合外科手术系列中,评估了升主动脉的临床病理特征。回顾性审查了513例行升主动脉组织手术切除的患者(1985年至1999年)的病历和显微幻灯片。患者为2至89岁(平均59岁),其中303例(59%)为男性。 479例手术是动脉瘤或夹层手术的指征。360例也切除了主动脉瓣。279例出现系统性高血压,67例患遗传性结缔组织病(ICTD),33例患动脉炎,16例获得性结缔组织病。囊性内侧变性(CMD)209例,主动脉夹层(AD)109例(CMD 56例),正常介质90例,主动脉炎57例(CMD 14例),其他发现48例。 CMD和AD的因子为ICTD(置信区间分别为7.61和2.26)。 AD患者的全身性高血压比非AD患者更常见(P = 0.0202)。正常介质是与二尖瓣主动脉瓣相关的最常见的组织学发现(P <0.0001)。在57例主动脉炎患者中(39个巨大细胞),年龄在16至85岁之间(平均64岁),其中42例(74%)为女性。只有8例患有高津动脉炎,11例患有颞部或全身性动脉炎。在手术切除的升主动脉中,最常见的3种组织学发现是CMD,AD和正常介质。 ICTD,系统性高血压和双尖瓣主动脉瓣是常见的合并症。巨细胞主动脉炎主要发生于女性,通常无全身性疾病。

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