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Syphilitic aortic aneurysm

Syphilitisches Aortenaneurysma

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Abstract

The aim of this study was to outline the clinical features of syphilitic aortic aneurysm. The study materials were based on a comprehensive literature review of publications on syphilitic aortic aneurysm published between 2000 and 2017. Syphilitic aortic aneurysm occurred most commonly in the ascending aorta in either a saccular or a fusiform shape. Syphilitic aortic aneurysm was often complicated by aortic valve insufficiency (in almost half of the patients), and by a coronary artery/ostium lesion in 16.5% of the patients. Aortic valve operation was necessary in one fourth, and coronary artery surgery accounted for less than one fifth of patients warranting a surgical treatment. Although there was no difference in the survival rates between the surgically and conservatively treated patients, an aggressive treatment should be performed when diagnosis is made due to the potential risks of aneurysm rupture and sudden death.

Zusammenfassung

Ziel der vorliegenden Studie war es, die klinischen Merkmale des syphilitischen Aortenaneurysmas zu umreißen. Das Material für diese Studie basiert auf einer umfassenden Literatursuche von Publikationen zum syphilitischen Aortenaneurysma aus den Jahren zwischen 2000 und 2017. Zumeist trat das syphilitische Aortenaneurysma in der Aorta ascendens auf, entweder als sackförmiges oder als spindelförmiges Aneurysma. Oftmals wurde das syphilitische Aortenaneurysma begleitet von der Komplikation einer Aortenklappeninsuffizienz (in fast der Hälfte der Fälle) und bei 16,5 % der Patienten von einer Koronararterien‑/Ostiumläsion. Bei einem Viertel der für eine chirurgische Behandlung infrage kommenden Patienten war eine Aortenklappenoperation notwendig und bei weniger als einem Fünftel ein chirurgischer Eingriff an den Koronararterien. Zwar bestanden keine Unterschiede bei den Überlebensraten zwischen den chirurgisch und den konservativ behandelten Patienten, aber eine aggressive Behandlung sollte bei entsprechender Diagnosestellung nur aufgrund der potenziellen Risiken der Aneurysmaruptur und des plötzlichen Todes erfolgen.

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  1. Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, 389 Longdejing Street, Chengxiang District, 351100, Putian, Fujian Province, China

    S.-M. Yuan MD, PhD

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U. Lange, Bad Nauheim

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Yuan, SM. Syphilitic aortic aneurysm. Z Rheumatol 77, 741–748 (2018). https://doi.org/10.1007/s00393-018-0519-1

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