Congenital Saccular Aneurysms of the Aortic Ring

IN SPITE OF, and also because of the great progress that has been made in the last decade in both clinical and basic research in the field of cardiovascular disease and in its application to the diagnosis and care of patients with heart disease, exact autopsy findings, in the event of death, have never been more important or more meaningful. With the rapid introduction of new technics, new tools, and new drugs aimed at more accurate diagnoses, a better evaluation of the patient, and more effective treatment, it has become increasingly clear that the pathologic anatomy of the heart is no longer the sole concern of the pathologist. This is encouraging to the pathologist who is only too keenly aware that observations made at the autopsy table, like observations made in other fields of medical research, are of little value to the patient until they can be translated into usefulness by the practicing physician. Indeed, a rebirth of interest by the younger clinicians in the pathology of the heart is leading to a growing awareness of the frequency, complexity, and variability of the structural manifestations of the many diseases and deformities of this organ. Furthermore, we are not only experiencing a renewed curiosity and interest in the more familiar and common patterns of disease, but also in the most uncommon. In brief, one is becoming more and more conscious of the uniqueness of the cardiovascular system of each individual and, as one would expect, no one has shown a greater interest in detailed postmortem findings than the younger welltrained cardiac diagnosticians and surgeons. It is freely admitted that most congenital malformations of the heart have at some time been recorded in the world 's literature. In actual practice, despite all of the modern diagnostic armamentarium at one's disposal, one does not diagnose beyond one 's realm of thought, so that the uncommon diseases and others that are not so uncommon are sometimes forgotten in one's differential diagnosis. For this reason, it seems worthwhile to continue to report some of the less common lesions that are found from time to time at the autopsy table: particularly those that would lend themselves to specific forms of modern therapy or, if encountered unexpectedly in the course of cardiac surgery, might be better understood in the interest of the patient. An unusual opportunity to observe three examples of congenital saccular aneurysm of varying size, in the region of the aortic ring during the past 3 years, carries with it the responsibility of bringing this type of lesion to the attention of others. Two of these were seen in adults, the third in a child 2 years of age who died suddenly shortly after admission to the hospital. This last case, which is of particular interest anatomically, is described in detail. Report of a Case