Identifying cardiovascular syphilis at operation

The American Journal of Cardiology
William Clifford RobertsBaron Lloyd Hamman

Abstract

To describe the morphologic features so the process can be easily identified during surgery, we studied 34 patients with cardiovascular syphilis, 32 of whom underwent excision and replacement of the ascending aorta or aortic valve or both. Of the 34 patients, 22 were treated at Baylor University Medical Center from 1998 to 2008 and 12 at non-Baylor University Medical Center hospitals from 1958 to 1987. In all 34 patients, the tubular portion of the aorta was diffusely thickened and the sinus portion of the aorta was apparently uninvolved. The process involved all 3 layers of the aorta, with thickening of the adventitia, mainly by fibrous tissue. Within the fibrous tissue were collections of plasma cells and lymphocytes, focal destruction of the media without thickening, and marked thickening of the intima by atherosclerotic-appearing lesions. Serologic tests for syphilis were done in only 14 patients (41%) and were positive (reactive) in 6 (43%) of them. The ascending aorta, however, was similar in all 34 patients. In conclusion, cardiovascular syphilis has not disappeared. Its identification during surgery can prompt appropriate antibiotic therapy postoperatively. Although the serologic test results for syphilis might be negat...Continue Reading

References

Feb 1, 1985·The American Journal of Cardiology·M A Silver, W C Roberts
Nov 1, 1949·American Heart Journal·M C THORNERG C GRIFFITH
Aug 26, 2006·The American Journal of Surgical Pathology·Dylan V MillerHenry D Tazelaar
Aug 26, 2006·The American Journal of Surgical Pathology·James L HommeHenry D Tazelaar

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Citations

Aug 27, 2015·The American Journal of Cardiology·William C RobertsA Carl Henry
Mar 7, 2015·International Immunopharmacology·Rui-Li ZhangLi-Jia Yang
Oct 27, 2010·International Journal of STD & AIDS·R SacksD Goldmeier
Aug 17, 2011·Vascular Medicine·Matthew I TomeyJoshua A Beckman
Dec 2, 2017·Journal of Forensic Sciences·Roger W Byard
Aug 4, 2018·Zeitschrift für Rheumatologie·S-M Yuan
Jun 1, 2016·International Journal of Paleopathology·Mario M CastroNicolas Castro

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