A Case Report of Coronary Malperfusion and Aortic Regurgitation Caused by Intimal Flap Associated with Localized Acute Aortic Dissection with Difficulty in Preoperative Diagnosis
- VernacularTitle:術前診断が困難であったバルサルバ洞内に限局した急性大動脈解離の1例
- Author:
Tetsuhiro URASHIMA
1
;
Kenji SAKAKIBARA
1
;
Hiroyuki NAKAJIMA
1
;
Yudai HAGIHARA
1
;
Chie NAKAMURA
1
;
Daichi SHIKATA
1
;
Yuuki TAKESUE
1
;
Satoru SHIRAIWA
1
;
Yoshihiro HONDA
1
;
Shigeaki KAGA
1
Author Information
- Keywords: sinus of Valsalva; localized acute aortic dissection; aortic root replacement
- From:Japanese Journal of Cardiovascular Surgery 2024;53(5):255-258
- CountryJapan
- Language:Japanese
- Abstract: A woman in her 60 s presented with chest pain. The electrocardiography showed ST depressed in V3-V6, ST elevation in aVR, and negative T in I, II, aVL, and aVF. Laboratory examination revealed that creatinine kinase isoenzyme-MB and troponin I were elevated. Transthoracic echocardiography revealed moderate aortic regurgitation. Enhanced computed tomography did not show an aortic dissection. Acute coronary syndrome was suspected and cardiac catheterization was done. Aortography showed an intimal flap inside the Valsalva sinus. An emergency operation was performed. Surgical view: the intimal tear affected almost all the circumference of the aorta in the Valsalva sinus and the aortic dissection with a localized and moving intimal flap affected the coronary flow and the aortic dissection caused severe aortic regurgitation and decreased the coronary flow. An aortic root replacement was successfully performed, and the postoperative course was uneventful.
