Type A aortic dissection with partial ostial occlusion of left main coronary artery.
A 48-year-old hypertensive male presented with acute retrosternal pain and aortic regurgitation. The electrocardiogram showed ST-segment depression with T-wave inversion in anterolateral leads. Transesophageal echocardiography in long axis view of aorta revealed a spiral intimal flap in ascending aorta extending to the arch, diagnostic of Type A aortic dissection. The short axis view of the aorta showed partial obstruction of the left main coronary artery (LMCA) by the intimal flap with turbulent flow at its ostium. An emergency repair of aortic dissection with reconstruction of aortic wall was done. Postoperative period and ECG were normal. At 12-months of follow up, patient was doing well.
Namboodiri
Narayanan
N
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695 011, India. kknnamboodiri@sctimst.ac.in
Krishnamoorthy
K M
KM
D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging*; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male