title: Acute type A aortic dissection in a patient with systemic lupus erythematosus.
abstract: The case of a 27-year-old Japanese woman with type A acute aortic dissection who had been diagnosed with systemic lupus erythematosus (SLE) is presented. The patient also had aortic regurgitation due to non-infective endocarditis and systemic hypertension, and had been maintained on steroid therapy for 15 years. Her twin sister was also diagnosed with SLE. The patient was admitted to emergency due to severe back pain. A chest x-ray showed enlargement of the upper mediastinum. Echocardiography revealed a thickened and deformed aortic valve with aortic regurgitation and dissection of the ascending aorta, but pericardial effusion was not found. Computed tomography demonstrated aortic dissection extending from the ascending aorta to the abdominal aorta. Graft replacement of the ascending aorta and proximal aortic arch was performed under hypothermic circulatory arrest with retrograde cerebral perfusion. The patient recovered uneventfully. Aortic dissection complicated with SLE is extremely rare, and this is only the 15th case reported in the English or Japanese literature.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Aoyagi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Akashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Otsuka
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakashita
authors.forename: Teiji
authors.initials: T
authors.lastname: Okazaki
authors.forename: aid Kei-ichiro
authors.initials: aK
authors.lastname: Tayama
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000209:etiology* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery; D002315:Cardiopulmonary Bypass; D002908:Chronic Disease; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D011239:Prednisolone / Q000008:administration & dosage
chemical_list: D011239:Prednisolone