Is Computed Tomography the Gold Standard in Aortic Dissection?

Year 2020, Volume: 11 Issue: 4, 101 - 103, 28.12.2020

Sefa Tatar Abdullah İçli Hakan Akıllı Niyazi Görmüş Ahmet Sertdemir

https://doi.org/10.33706/jemcr.789856

Abstract

İntroduction:
Aortic dissection is a disease with high mortality, which is characterized by a tear in the aortic wall. Thanks to early diagnosis and treatment, patients' survival rates are high. Chest pain is the most common symptom. Imaging methods help in diagnosis. Its treatment is surgery.
Case report:
A 47-year-old male patient was admitted to the emergency department with chest pain. The diagnosis of aortic dissection in computed tomography was evaluated as motion artifact and valve motion, and he was asked to be discharged from the emergency service after his diagnosis was missed. However, transesophageal echocardiography was performed because of the patient's clinical symptom and echocardiographic findings supported the aortic dissection. When a dissection flap was seen in transesophageal echocardiography, the patient was transferred to surgery. In surgery, a dacron graft was placed in the patient's aorta and a prosthetic valve was placed on the aortic valve, and left main coronary repair and right coronary is bypass were performed. The patient was discharged without any problem.
Conclusion:
Aortic dissection is a clinical diagnosis, it is a disease with high mortality. Imaging methods are helpful in diagnosis, but the fact that imaging methods rule out dissection does not always rule out the disease. The important thing is to suspect the disease and to consider the patient's current clinical symptoms and signs.

Keywords

Aortic dissection, computered tomography, transeosefageal echocardiography, surgery

References

• 1- Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Russman PL. The International Registry of Acute Aortic Dissection (IRAD): New insights into an old disease. JAMA. 2000;283:897-903
• 2- Khan IA, Nair CK. Clinical, diagnosis, and management perspectives of aortic dissection. Chest. 2002;122:311-8.
• 3- Akgün FS, Turtay MG, Dişli OM, Oğuztürk H, Doğan M. Bacak ağrısıyla karakterize akut aort diseksiyonu. Genel Tıp Derg. 2011;21: 155-7
• 4- Mumcu S, Akgün M, Örken DN. Nörolojik bozulma ile baş gösteren aort diseksiyonu olguları. Türk Nöroloji Dergisi. 2014; 20: 51-3
• 5- Ramanath VS, Eagle KA, Nienaber CA. The role of preoperative coronary angiography in the setting of type A acute aortic dissection: İnsights from the International Registry of Acute Aortic Dissection. Am Heart J. 2011;161(4):790- 796.
• 6- Wang ZG, Zhao W, Shen BT. Successful treatment of a case of acute myocardial infarction due to type A aortic dissection by coronary artery stenting: A case report. Exp Ther Med. 2015;10(2):759-762.
• 7- Kourliouros A, Soni M, Rasoli. Evolution and current applications of the Cabrol procedure and its modifications. Ann Thorac Surg. 2011;91(5):1636-41.