title: Prolapse of aortic intimal flap into the left ventricle: a rare cause of global myocardial ischemia in acute type A aortic dissection.
abstract: A 62-year-old woman experienced an acute type A aortic dissection complicated with profound shock caused by acute myocardial ischemia. Intraoperative transesophageal echocardiography (TEE) identified a circumferentially dissected intimal flap at 5.5 cm above the aortic valve, prolapsing into the left ventricle through the aortic valve during diastole and obstructing both coronary ostia. Acute aortic dissection must be kept in mind when presented with myocardial ischemia and TEE is the most useful method for detecting a prolapsing cylindrical intimal flap.
authors.affiliation: Department of Cardiovascular Surgery, Fukushima Medical University School of Medicine1 Hikarogaoka, Fukushima 960-1295, Japan. yoichi-s@fmu.ac.jp
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Hirono
authors.initials: H
authors.lastname: Satokawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Takase
authors.forename: Yukitoki
authors.initials: Y
authors.lastname: Misawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yokoyama
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002303:Cardiac Output, Low / Q000209:etiology; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011391:Prolapse; D012769:Shock / Q000209:etiology