Intimal intussusception in aortic dissection and coexisting coronary artery disease

Ann Thorac Surg. 2014 Feb;97(2):698-700. doi: 10.1016/j.athoracsur.2013.05.110.

Abstract

Intimal tear is rarely circumferential in aortic dissection. In such an instance, intimal intussusception may occur. This exposes the patient to the additional risk of severe aortic regurgitation, blockage of the left main coronary artery ostium, or both in proximal intimal intussusception in ascending aortic dissection. Here we present a 61-year-old patient with ascending aortic dissection, aortic regurgitation caused by an intussuscepted proximal intimal flap, and coexisting coronary artery disease. The presenting symptoms and electrocardiographic findings simulated an acute coronary syndrome. Among other diagnostic measures, only transesophageal echocardiography clearly defined the pathologic condition. The patient underwent a successful aortic root replacement and coronary artery bypass grafting.

Keywords: 23; 26.

Publication types

  • Case Reports

MeSH terms

  • Aortic Aneurysm, Thoracic / complications*
  • Aortic Aneurysm, Thoracic / pathology*
  • Aortic Dissection / complications*
  • Aortic Dissection / pathology*
  • Aortic Valve Insufficiency / etiology*
  • Coronary Artery Disease / complications*
  • Humans
  • Male
  • Middle Aged
  • Tunica Intima*