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Raphael Bueno
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J Thorac Cardiovasc Surg 2004;128:761-762
© 2004 The American Association for Thoracic Surgery

Brief communication

Sarcoidosis of the aortic root

Hrvoje Gasparovic, MDa, Raphael Bueno, MDb, Frank J. Rybicki, MD, PhDc, Kenneth L. Baughmann, MDd, Robert C. Capodilupo, MDe, Marzia Leacche, MDa, John G. Byrne, MDa,*

a Cardiac Surgery, Brigham and Women's Hospital, Boston, Mass, USA,
b Thoracic Surgery, Brigham and Women's Hospital, Boston, Mass, USA,
c Department of Radiology, Brigham and Women's Hospital, Boston, Mass, USA,
d Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass, USA
e Northeast Cardiology, Eastern Maine Medical Center, Bangor, Maine, USA

Received for publication March 12, 2004; accepted for publication March 26, 2004.

* Address for reprints: John G. Byrne, MD, Division of Cardiac Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA
JBYRNE@PARTNERS.ORG

The first 20% of the full text of this article appears below.

Sarcoidosis is a clinical entity characterized by noncaseating epithelioid granulomas affecting multiple organs. The cause remains perplexing, but the available evidence points to an exaggerated cellular response as the feature of the disorder. The granulomas, composed of mononuclear phagocytes encircled by CD4 T lymphocytes, have the potential for distorting tissue architecture and thus compromising organ function. Sarcoidosis is a systemic disease, but its symptoms are usually secondary to lung, liver, skin, lymph node, and eye involvement. Clinically manifest cardiac involvement is seen in 5% of patients. It is characterized by conduction anomalies, pericarditis, and congestive heart failure, with the potential for causing sudden death. We report on an unusual case of cardiac sarcoidosis resulting in aortic valve insufficiency and left ventricular outflow tract (LVOT) obstruction.

Clinical summary

A 56-year-old man with a 5-year history of a heart murmur recently had a syncopal episode after newly discovered complete heart block. A transvenous temporary pacing wire was immediately inserted, followed by a permanent atrioventricular sequential pacemaker. Of note, his previous medical history was . . . [Full Text of this Article]






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