Identifying cardiovascular syphilis at operation

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Pathology

Background:

• Cardiovascular syphilis remains a significant clinical concern, impacting the aorta.
• Morphologic identification during surgical procedures is crucial for diagnosis.

Purpose of the Study:

• To detail the specific morphologic characteristics of cardiovascular syphilis in the ascending aorta.
• To aid surgeons in identifying this condition during operative interventions.

Main Methods:

• Retrospective analysis of 34 patients with cardiovascular syphilis.
• Review of surgical findings from ascending aorta or aortic valve replacement procedures.
• Histopathologic examination of aortic tissue.

Main Results:

• Diffuse thickening of the tubular aorta, with uninvolved aortic sinuses.
• Involvement of all three aortic layers: thickened adventitia, media destruction, and intima thickening.
• Atherosclerotic-appearing lesions in the intima; syphilis serology positive in only 43% of tested patients.

Conclusions:

• Cardiovascular syphilis is still prevalent and exhibits characteristic surgical morphologic features.
• Surgical identification is key, even with negative serologic tests for syphilis.
• Postoperative antibiotic therapy is recommended for patients with panaortitis requiring aortic resection.