Prolapse of aortic intimal flap into the left ventricle: a rare cause of global myocardial ischemia in acute type A aortic dissection.
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.
Sato
Yoichi
Y
Department of Cardiovascular Surgery, Fukushima Medical University School of Medicine1 Hikarogaoka, Fukushima 960-1295, Japan. yoichi-s@fmu.ac.jp
Satokawa
Hirono
H
Takase
Shinya
S
Misawa
Yukitoki
Y
Yokoyama
Hitoshi
H
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