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

• Main Authors: Maryam Mehrpooya, Mehrdad Salehi, Ramin Eskandari, Zeinab Shajirat, Allahyar Golabchi, Majid Mazoochi
• Format: Article
• Language: English
• Published: Vesnu Publications 2012-10-01
• Series: ARYA Atherosclerosis
• Online Access: http://arya.mui.ac.ir/index.php/arya/article/view/439

<span style="font-family: Times New Roman; font-size: small;"> </span><p class="MsoNormal" style="margin: 0cm 28.1pt 0pt 28pt; text-indent: 0.35pt;"><span style="font-family: Times New Roman;"><strong><span style="font-size: 9pt; mso-bidi-font-size: 12.0pt;">BACKGROUND:</span></strong><span style="font-size: small;"> </span></span><span style="font-family: &quot;Georgia&quot;,&quot;serif&quot;; font-size: 10pt; mso-ansi-language: EN-GB; mso-bidi-language: FA; mso-bidi-font-style: italic;" lang="EN-GB">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.</span></p><span style="font-family: Times New Roman; font-size: small;"> </span><p class="abstract" style="margin: 3pt 1cm 0pt;"><strong><span style="mso-bidi-font-size: 13.0pt;"><span style="mso-tab-count: 1;"><span style="font-family: Georgia; font-size: x-small;"> </span></span></span></strong><strong><span style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 9pt; mso-bidi-font-size: 12.0pt; mso-bidi-language: AR-SA;">CASE REPORT: </span></strong><span style="font-size: x-small;"><span style="font-family: Georgia;"><span style="mso-ansi-language: EN-GB; mso-bidi-font-style: italic;" lang="EN-GB">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</span>.</span></span></p><span style="font-family: Times New Roman; font-size: small;"> </span><p class="abstract" style="margin: 3pt 1cm 0pt;"><strong><span style="font-size: 9pt; mso-bidi-font-size: 10.0pt;"><span style="mso-tab-count: 1;"><span style="font-family: Georgia;"> </span></span></span></strong><strong><span style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 9pt;">CONCLUSION:</span></strong><span style="font-size: x-small;"><span style="font-family: Georgia;"> <span style="mso-ansi-language: EN-GB;" lang="EN-GB">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.</span></span></span></p><span style="font-family: Times New Roman; font-size: small;"> </span><p class="abstract" style="margin: 3pt 1cm 0pt;"><span style="font-size: 11pt;"><span style="font-family: Georgia;"> </span></span></p><span style="font-family: Times New Roman; font-size: small;"> <br style="mso-ignore: vglayout;" /> </span><p class="abstract" style="margin: 3pt 1cm 0pt;"><span style="font-size: x-small;"><strong><span style="font-family: &quot;Times New Roman&quot;,&quot;serif&quot;;">Keywords:</span></strong><span style="font-family: Georgia;"> <span style="mso-ansi-language: EN-GB;" lang="EN-GB">Saccular Aneurysm, Aortic Dissection, Pseudoaneurysm, Aneurysm.</span></span></span></p><span style="font-family: Times New Roman; font-size: small;"> </span>