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Acute aortic dissection without intimal tear

J Utoh1, H Goto, T Hirata

  • 1First Department of Surgery, Kumamoto University School of Medicine, Japan.

The Journal of Cardiovascular Surgery
|August 1, 1997
PubMed
Summary
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A rare case of acute aortic dissection without an intimal tear was surgically confirmed. This finding is unusual, as intimal tears are typically identified in aortic dissections.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Medicine

Background:

  • Acute aortic dissection is a life-threatening condition involving a tear in the aorta's inner layer.
  • Stanford type-B aortic dissection typically originates in the descending thoracic aorta.
  • The presence of an intimal tear is a commonly accepted prerequisite for aortic dissection.

Observation:

  • A 68-year-old woman presented with acute Stanford type-B aortic dissection.
  • Progressive anemia and pleural leakage necessitated surgical intervention.
  • Intraoperative findings revealed a false lumen filled with hematoma in the descending thoracic aorta.

Findings:

  • No intimal defect or tear was identified during surgical exploration.
  • This case represents a rare instance of surgically confirmed aortic dissection without an intimal tear.

Related Experiment Videos

  • Previous reports of such cases relied on indirect imaging or autopsy findings.

    • Implications:

    • Challenges the traditional understanding of aortic dissection etiology.
    • Highlights the importance of considering alternative mechanisms for aortic dissection.
    • May influence diagnostic and surgical approaches for complex aortic dissections.