主动脉右乏氏窦瘤破裂误诊为瓣周脓肿1例

Right aortic sinus of Valsalva aneurysm rupture misdiagnosed as abscess around valve:One case report

1病例资料 患者,男,64岁,因反复胸痛半年,2个月前有发热病史,最高体温38.4℃,WBC 12×10^9/L,中性粒细胞6.7×10^9/L,遂来我院就诊。体检：胸骨右缘第3~4肋间闻及以舒张期为主连续性吹风样杂音Ⅲ-Ⅳ级。行超声心动图检查：全心腔增大,主动脉右冠窦形成大小25mm×18mm椭圆状无回声向右心室膨出（图1a）,其壁回声增强增粗,无回声区内有一宽约5mm破口与主动脉腔相通,另有一宽约3mm破口与右室流出道相通。

The clinical manifestation was repeated chest pain for half a year.Two months ago,the patient had a history of fever.White blood cells were 12×10^9/L,neutrophils were 6.7×10^9/L.Ⅲ-Ⅳ/6 continuity diastolic murmur was heard in the right edge of the sternum.Ultrasound showed that aortic paravalvular abscess ruptured into the right ventricular outflow tract.After operation,the patient was diagnosed with right ventricular aneurysm ruptured into right ventricular outflow tract.