Giant Aortic Root Thrombus in a Chronic, Asymptomatic Stanford Type A Aortic Dissection

Area of Science:

• Cardiology
• Vascular Surgery
• Medical Diagnostics

Background:

• Type A aortic dissection typically presents acutely with high early mortality.
• Chronic aortic dissection is uncommon, with specific indicators like false lumen thrombus and immobile intimal flaps.
• Early misdiagnosis can delay appropriate management of aortic pathologies.

Purpose of the Study:

• To report a rare case of chronic Stanford Type A aortic dissection.
• To emphasize the diagnostic significance of thrombus and an immobile flap in chronic aortic dissections.
• To illustrate the potential for delayed diagnosis and presentation with significant valvular complications.

Main Methods:

• Case report of a 61-year-old male patient.
• Review of clinical presentation, including initial misdiagnosis.
• Diagnostic imaging utilizing echocardiography to assess aortic anatomy and function.

Main Results:

• The patient presented with a diastolic murmur, suggesting aortic regurgitation.
• Echocardiography confirmed chronic Stanford Type A aortic dissection.
• A thrombus within the false lumen was identified as the cause of severe aortic regurgitation.

Conclusions:

• Chronic Type A aortic dissection, though rare, can occur and may be indicated by specific imaging findings.
• Thrombus in the false lumen and an immobile flap are crucial indicators of chronicity.
• Accurate and timely diagnosis is essential to manage complications such as severe aortic regurgitation.