Related Experiment Video

Updated: Aug 7, 2026

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

[Bilateral coronary ostial stenoses with aortic regurgitation in a patient with syphilitic aortitis]

H Tsukui1, E Koh, S Yokoyama

  • 1Department of Cardiovascular Surgery, Kyoto Second Red Cross Hospital, Kyoto, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 15, 2003
PubMed

Insights

Syphilitic aortitis can cause severe coronary ostial stenosis and aortic regurgitation. Prompt surgical intervention with aortic valve replacement and coronary artery bypass grafting using internal thoracic arteries is crucial for successful outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Cardiology

Background:

  • Syphilitic aortitis, a rare complication of syphilis, can lead to significant cardiovascular issues.
  • It often presents with coronary ostial stenosis and aortic regurgitation, which can be overlooked.

Observation:

  • A 61-year-old male presented with chest pain due to syphilitic aortitis-induced coronary ostial stenoses (90% and 99%) and severe aortic regurgitation.
  • Diagnostic tests confirmed active syphilis with high titers.

Findings:

  • Surgical intervention included aortic valve replacement and coronary artery bypass grafting using bilateral internal thoracic arteries.
  • Angiographic features included ostial stenosis (>90%) and associated aortic regurgitation.
  • Internal thoracic arteries are preferred over saphenous vein grafts to prevent graft occlusion.

Implications:

  • This case highlights the importance of considering syphilitic aortitis in patients with unexplained coronary ostial stenosis and aortic valve disease.
  • Optimal surgical strategy involves utilizing internal thoracic arteries for CABG and considering retrograde cardioplegia for severe ostial stenosis.

More Related Videos

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

A Minimally Invasive Model of Aortic Stenosis in Swine06:51

A Minimally Invasive Model of Aortic Stenosis in Swine

Published on: October 20, 2023

Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...