Diagnostic dilemma: Saccular aneurysm or pseudoaneurysm of the ascending aorta with dissection above level of leaflets

Mehrpooya, M. and Salehi, M. and Eskandari, R. and Shajirat, Z. and Golabchi, A. and Mazoochi, M. (2012) Diagnostic dilemma: Saccular aneurysm or pseudoaneurysm of the ascending aorta with dissection above level of leaflets. ARYA Atherosclerosis, 8 (3). p. 8.

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Abstract

BACKGROUND: In true aneurysm, the wall of aneurysm is composed of the normal histological components of aorta. A false aneurysm (pseudoaneurysm) represents a rupture which does not contain the normal histological components of aorta. It is a fibrous peel that has formed from a small perforation of aorta. We describe an unusual presentation that has signs which some of them are only manifested in true aneurysm and some others only in pseudoaneurysm. CASE REPORT: An 85-year-old man underwent elective coronary angiography for chest pain work-up. Our evaluation by invasive angiography and CT angiography showed aortic dissection. In surgery we found that dissection flap was composed of some parts of intima and media layers. These signs leaded to confusing symptoms. Localized bulging of ascending aorta had continued to brachiocephalic artery (transverse arch involvement). Dissection flap was composed of some part of intima and media layers. It was a strange case, it was not solely a perivascular hematoma and it did not have all three layers of aorta wall. Partial aorta replacement was performed. The operation and recovery was uneventful. CONCLUSION: This unusual presentation of disease has not been mentioned in literatures. Our experience can help to manage similar cases. This case was the first unusual presentation of its type.

Item Type: Article
Additional Information: cited By 1
Uncontrolled Keywords: troponin, acute coronary syndrome; aged; angiocardiography; aorta aneurysm; aorta arch syndrome; aorta dissection; aorta graft; aorta intima; aorta media; aorta reconstruction; aorta thrombosis; aortography; article; ascending aorta; case report; clinical feature; computed tomographic angiography; conventional angiography; ECG abnormality; false aneurysm; heart catheterization; hematoma; human; male; radiodiagnosis; rare disease; saccular aneurysm; thorax pain; thorax radiography; transthoracic echocardiography; treatment outcome
Subjects: Medicine
Divisions: Faculty of Medicine > Clinical Sciences > Department of Cardiology
Depositing User: editor . 2
Date Deposited: 01 Mar 2017 13:36
Last Modified: 01 Mar 2017 13:36
URI: http://eprints.kaums.ac.ir/id/eprint/740

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