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Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
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Unusual complication of aortic dissections: intimo-intimal intussusception
Unsal Vural1, Ahmed Yavuz Balci2, Ahmet Arif Aglar2
1Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey. unsalvural@gmail.com.
Cardiovascular Journal of Africa
|September 26, 2015
Summary
This case study highlights intimo-intimal intussusception, a rare aortic dissection variant. Early diagnosis via transesophageal echocardiography is crucial for effective surgical intervention in acute coronary syndrome patients.
Area of Science:
- Cardiovascular Surgery
- Diagnostic Imaging
- Vascular Medicine
Background:
- A 76-year-old female presented with chest pain and syncope, initially diagnosed with acute coronary syndrome.
- Type III aortic dissection was identified, prompting referral for specialized care.
Observation:
- CT angiography revealed a 57 mm ascending aorta without a dissection flap, but showed intimo-intimal intussusception, left common carotid artery occlusion, and a double-channel aorta.
- Transesophageal echocardiography confirmed an enlarged ascending aorta and suggested aortic arch hematoma and intimo-intimal intussusception.
Findings:
- The patient underwent resection of the intimo-intimal intussusception flap and supracoronary graft replacement of the ascending aorta.
- Transesophageal echocardiography demonstrated high sensitivity and specificity for diagnosing intimo-intimal intussusception.
Implications:
- This case underscores the importance of considering rare aortic pathologies in patients presenting with acute coronary syndromes.
- Effective surgical management, guided by advanced imaging, is critical for favorable outcomes in complex aortic dissections.
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