title: Ruptured penetrating ulcer of the ascending aorta with pulmonary artery compression.
abstract: Pulmonary artery involvement has been reported in various degrees of complicated dissection of the ascending aorta. The prognosis remains poor without high-risk surgical intervention, but conservative management can be considered in high-risk cases. We report a case of nonoperative management of an octogenarian who presented with a contained rupture of his proximal ascending aorta, likely from a penetrating atherosclerotic ulcer. It was complicated by extrinsic compression of the pulmonary trunk and transient pulmonary hypertension without features of acute right heart failure. He remained alive at the one-year follow-up.
authors.affiliation: Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia nokiwelu@gmail.com.
authors.forename: Ngozichukwuka
authors.initials: N
authors.lastname: Okiwelu
authors.affiliation: Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Finn
authors.affiliation: Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Rohan
authors.initials: R
authors.lastname: Vanden Driesen
authors.affiliation: Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Lucas
authors.initials: L
authors.lastname: Sanders
authors.affiliation: Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Pragnesh
authors.initials: P
authors.lastname: Joshi
mesh_terms: D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001019:Aortic Rupture / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D062186:Arterial Pressure; D003251:Constriction, Pathologic; D015150:Echocardiography, Doppler; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000959:Antihypertensive Agents
keywords: 80 and over; Aged; Aortic aneurysm; Aortic diseases; Ulcer