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J Thorac Cardiovasc Surg 2003;125:1546-1548
© 2003 The American Association for Thoracic Surgery

Brief Communications

Proximal prolapse of aortic intimal flap: A rare complication of acute type A aortic dissection

G. Hossein Almassi, MD Milwaukee, Wis

From the Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wis.

Received for publication July 30, 2001. Accepted for publication Feb 15, 2002. Address for reprints: G. Hossein Almassi, MD, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Froedtert East Clinic, PO Box 26099, Milwaukee, WI 53226 (E-mail: galmassi@mcw.edu).

The first 20% of the full text of this article appears below.

Acute type A aortic dissection requires emergency surgical repair to prevent the known life-threatening complications of rupture, cardiac tamponade, acute coronary ischemia, and branched arterial occlusion. Prolapse of the intimal flap into the distal ascending aorta and the aortic arch has been reported in cases of circumferential tear of the aortic intima.Go Go 1-4 We report a case of acute type A aortic dissection with intussusception of the intimal flap proximally into the aortic root and the left ventricular outflow tract, causing global myocardial ischemia.

A 75-year-old man had acute chest pain and shortness of breath. He was hypotensive, and the electrocardiogram disclosed global ST-segment depression in leads I, II, III, AVL, and AVF and precordial leads V2 to V6. Medical history included severe chronic renal insufficiency, coronary artery bypass grafting 10 . . . [Full Text of this Article]






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