Spontaneous retrograde dissection of ascending aorta from descending thoracic aorta--a case review.

摘要: A 56-year-old man with sudden onset chest pain, absent right lower limb pulses and ECG changes suggestive of inferior ST elevation MI underwent coronary angiogram through the radial artery a view to primary percutaneous intervention (PCI). The left demonstrated severe proximal stenotic disease in anterior descending circumflex arteries, but could not be selectively cannulated. An ascending aortogram visualise only failed demonstrate it, revealed, instead, dissection flap aorta, arch thoracic moderately aortic regurgitation. At operation, patient was found have an acute aorta entry tear below subclavian origin. Triple bypass grafting re-suspension valve, supracoronary replacement hemiarch transaortic repair performed. made uncomplicated recovery, re-appearance pulses. postoperative magnetic resonance (MR) scan revealed complete thrombosis false channel residual considerably shrunken no Retrograde from has been reported infrequently past. We believe scale problem underestimated because failure adopt open distal anastomosis routinely past and, hence, inspect routinely, particularly when intimal identified aorta. as such, managed, either on principle exclusion by various elephant trunk procedures their variants or, alternatively, excision extended one-stage replacement, usually combined procedure. Neither these is widely adopted, owing procedural, institutional outcome considerations. describe interposition graft excellent clinical radiological result. also review diagnostic therapeutic approaches this incompletely understood lethal disease.