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Spontaneous resolution late after aortic dissection
C J Zeebregts1, M A Schepens, F E Vermeulen
1Department of Surgery, University Hospital, Groningen, The Netherlands.
Insights
This case study highlights a rare instance of spontaneous resolution in a dissected descending aorta following surgery for acute type I aortic dissection. Despite initial complications, the aorta fully healed over time, offering a unique insight into aortic dissection recovery.
Area of Science:
- Cardiovascular Surgery
- Vascular Medicine
- Radiology
Background:
- Acute type I aortic dissection requires surgical intervention, often involving aortic graft replacement.
- Postoperative complications such as double-barrelled aorta can occur, necessitating long-term monitoring.
- The natural history and potential for spontaneous resolution of complex aortic dissections remain areas of interest.
Abstract:
A 50-year-old man was operated on for acute type I (DeBakey classification) aortic dissection. The supracoronary ascending aorta was replaced with an interposition graft. Postoperative computed tomography and angiography clearly revealed a double-barrelled aortic arch, left common carotid artery and descending thoracoabdominal aorta with contrast filling of both true and false lumen starting from the distal anastomosis. The same finding was noted at 1 year follow-up with severe compression of the true lumen by the false lumen. At this time, anticoagulation therapy was stopped. One year later, computed tomography showed spontaneous resolution of the dissection in the aortic arch, left common carotid artery and descending aorta over its full length. This was confirmed by angiography. This case reports illustrates that spontaneous resolution of a dissected descending aorta can occur late after surgery from type 1 dissection, but it remains very rare.