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Circumferential Fibrosis of the Ascending Aorta After COVID Infection

Charles S Roberts1, William C Roberts2

  • 1Departments of Cardiac Surgery, Baylor University Medical Center; Baylor University Medical Center (BUMC); Heart and Vascular Institute of BUMC, Dallas, Texas.

The American Journal of Cardiology
|October 2, 2022
PubMed

Insights

Severe COVID-19 survivors experienced chest pain due to unusual aortic inflammation. Post-infection, dense fibrous tissue and plasma cells encased the aorta, mimicking dissection without a tear.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Pathology

Background:

  • COVID-19 is a severe respiratory illness with potential systemic complications.
  • Aortic dissection is a serious cardiovascular emergency involving a tear in the aorta's inner layer.

Observation:

  • Two women developed chest pain after recovering from severe COVID-19.
  • Computed tomographic angiography suggested acute ascending aortic dissection in both patients.

Findings:

  • Surgical exploration revealed the ascending aorta encased in dense fibrous tissue.
  • Focal collections of mononuclear cells, predominantly plasma cells, were observed within the fibrous tissue.
  • No evidence of an intimal tear or dissection was found, despite initial imaging suggesting otherwise.

Implications:

  • This presentation suggests a novel inflammatory process affecting the aorta post-COVID-19.
  • The findings highlight the need to consider unusual aortic pathologies in patients with a history of severe COVID-19.
  • Further research is warranted to understand the mechanism and long-term consequences of this COVID-19-associated periaortic inflammation.

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