Incorrect Diagnosis of Type A Aortic Dissection Attributed to Motion Artifact During Computed Tomographic

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Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
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Jeremy M Bennett1, Bantayehu Sileshi

  • 1From the Division of Cardiovascular Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.

A & a Case Reports
|July 11, 2017
PubMed

Insights

Early diagnosis of aortic dissection is crucial. Computed tomography angiography (CTA) can yield false positives; transesophageal echocardiography confirmed no dissection in one case, preventing unnecessary surgery.

Area of Science:

  • Cardiovascular Imaging
  • Diagnostic Accuracy
  • Thoracic Surgery

Background:

  • Early diagnosis of aortic dissection is critical for reducing mortality.
  • Standard treatment for aortic dissection involves surgical management.
  • Current diagnostic methods include CTA, MRI, arteriography, and TEE, each with potential for false positives.

Observation:

  • A patient diagnosed with type A aortic dissection via CTA was evaluated.
  • Transesophageal echocardiography (TEE) under general anesthesia was performed for further assessment.
  • Echocardiographic findings indicated the initial CTA results may have been artifactual.

Findings:

  • The patient was found to not have an aortic dissection upon TEE.
  • This finding prevented an unnecessary sternotomy and surgical intervention.
  • CTA artifact was suggested as the cause of the initial misdiagnosis.

Implications:

  • TEE can serve as a crucial tool to confirm or refute CTA findings in suspected aortic dissections.
  • Avoiding unnecessary surgeries based on accurate imaging interpretation can improve patient outcomes.
  • This case highlights the importance of multi-modal imaging and careful interpretation in diagnosing aortic dissection.

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