title: Spontaneous aortic dissection limited to sinus of Valsalva and involving the left main coronary artery.
abstract: Aortic dissection limited to one sinus of Valsalva has been described exclusively as an iatrogenic complication during catheterization interventions. This life-threatening subtype had a very small area of dissection, when coronary ostia are frequently involved. We report a 43-year-old man with dissection limited to left sinus of Valsalva, involving the left main coronary artery and causing non-ST-myocardial infarction, including severe reversible ST-depression, maximum of 9 mm in V5 lead. Dissection was suggested by cineangiography, transesophageal echocardiogram, and contrast-enhanced multidetector computed tomography. Surgical treatment was successful. There were not any associated diseases in the sinuses of Valsalsa, aortic valve or coronary arteries. Unlike previous reported cases of aortic dissection with such limited localization, the present case was spontaneous, and not iatrogenic.
authors.affiliation: Heart Institute (InCor) , University of São Paulo Medical School, Av. Doutor Enéas Carvalho Aguiar 44, 05403.900 São Paulo, Brazil. caio.vianna@incor.usp.br
authors.forename: Caio B
authors.initials: CB
authors.lastname: Vianna
authors.forename: Luiz B
authors.initials: LB
authors.lastname: Puig
authors.forename: Marcelo L
authors.initials: ML
authors.lastname: Vieira
authors.forename: Afonso A
authors.initials: AA
authors.lastname: Shiozaki
authors.forename: Demetrio
authors.initials: D
authors.lastname: Dauar
authors.forename: Luiz A
authors.initials: LA
authors.lastname: Cesar
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001014:Aortic Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002932:Cineangiography; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology* / Q000601:surgery; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology* / Q000473:pathology; D012850:Sinus of Valsalva / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures