Leaking giant aneurysm of the aortic root due to cystic medial necrosis with pericardial tamponade mimicking type-A aortic dissection

Détails

ID Serval
serval:BIB_C851D8A7540E
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Leaking giant aneurysm of the aortic root due to cystic medial necrosis with pericardial tamponade mimicking type-A aortic dissection
Périodique
Thoracic and Cardiovascular Surgeon
Auteur(s)
Attenhofer  C. H., Vogt  P. R., von Segesser  L. K., Dirsch  O. R., Ritter  M., Jenni  R.
ISSN
0171-6425
Statut éditorial
Publié
Date de publication
04/1996
Peer-reviewed
Oui
Volume
44
Numéro
2
Pages
103-4
Notes
Case Reports
Journal Article --- Old month value: Apr
Résumé
The diagnosis of acute type-A aortic dissection is predominantly based on the demonstration of an intimal tear or a dissection membrane. We describe another pathogenetic mechanism in a patient with the typical features of acute aortic dissection with pericardial tamponade, and a giant aneurysm of the ascending aorta. However, no dissection membrane, rupture site, or intimal tear could be demonstrated by transesophageal echocardiography, intraoperatively, or histologically. The histological work-up showed an extreme form of cystic medial necrosis with intramural hemorrhages consistent with a leaking aneurysm. Hence, in a patient with a symptomatic aneurysm of the aortic root and pericardial tamponade, obvious intimal dissection or rupture does not always have to be present echocardiographically or intraoperatively. A different presentation can occur in the setting of an extreme medial necrosis, where blood leaks through the aortic wall causing intramural hemorrhages with intimal leaks invisible to the surgeon's or echocardiographer's eye. This process is clinically indistinguishable from type-A aortic dissection.
Mots-clé
Aneurysm, Dissecting/classification/diagnosis/*etiology Aorta/*pathology Aortic Aneurysm/diagnosis/*etiology/surgery Cardiac Tamponade/*etiology Causality Diagnosis, Differential Humans Male Middle Aged Necrosis Tunica Media/*pathology
Pubmed
Web of science
Création de la notice
14/02/2008 15:16
Dernière modification de la notice
20/08/2019 16:43
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