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Related Concept Videos

Aneurysm I: Introduction01:30

Aneurysm I: Introduction

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aneurysm III: Interprofessional Care01:26

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Abdominal Aorta01:25

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Once the aorta traverses the diaphragmatic plane at the aortic hiatus, it is known as the abdominal aorta. This anatomical structure is positioned leftward of the spinal column, encased within a cocoon of adipose tissue behind the peritoneal cavity. It terminates at the L4 vertebra, where it splits into the common iliac arteries. Prior to this bifurcation, the abdominal aorta gives rise to several vital branches.
The celiac trunk, a singular artery, divides into the left gastric artery, which...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Multimodality Diagnosis of Mesenteric Ischemia
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Localized Aortic Root Dissection with a Superior Mesenteric Artery Aneurysm.

Akihiko Ikeda1, Tomomi Nakajima1, Yuji Hiramatsu2

  • 1Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.

Annals of Vascular Diseases
|November 18, 2017
PubMed
Summary

Transesophageal echocardiography (TEE) is crucial for detecting localized aortic root dissection, especially when CT angiography is inconclusive. A coexisting superior mesenteric artery (SMA) aneurysm may indicate underlying aortic wall vulnerability.

Keywords:
aortic dissectionemergency surgerysuperior mesenteric aneurysm

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Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • Aortic dissection is a life-threatening condition involving a tear in the aorta's inner layer.
  • Localized aortic root dissection can be challenging to diagnose, particularly when the intimal flap is not clearly visualized.
  • Coexisting vascular pathologies may suggest underlying systemic connective tissue abnormalities or shared risk factors.

Purpose of the Study:

  • To report a case of localized aortic root dissection coexisting with a superior mesenteric artery (SMA) aneurysm.
  • To highlight the diagnostic utility of transesophageal echocardiography (TEE) in cases of suspected aortic root dissection.
  • To emphasize the importance of considering associated vascular lesions in the diagnostic workup.

Main Methods:

  • Case report of a 46-year-old female patient.
  • Initial imaging with computed tomographic angiography (CTA).
  • Confirmatory diagnosis using transesophageal echocardiography (TEE).

Main Results:

  • CTA revealed a superior mesenteric artery (SMA) aneurysm but could not clearly delineate an intimal flap in the aortic root.
  • TEE successfully visualized the intimal flap, confirming localized aortic root dissection.
  • The presence of SMA aneurysm suggested a potential vulnerability of the aortic wall.

Conclusions:

  • Transesophageal echocardiography (TEE) is a highly effective tool for diagnosing localized aortic root dissection.
  • The identification of one vascular lesion, such as an SMA aneurysm, should prompt a thorough investigation for other coexisting vascular abnormalities.
  • This case underscores the value of multimodal imaging in complex cardiovascular diagnoses.