Aortic aneurysm and dissection - Stanford type A

Case contributed by Assoc Prof Craig Hacking

Presentation

Chest pain

Patient Data

Age: 70 years
Gender: Female

Massively aneurysmal aorta displacing the trachea to the right. Right main bronchus narrowing.

Consolidation in the left lower lobe. Small adjacent left pleural effusion.

Aortic dissection confirmed, arising from the ascending aorta (Stanford type A) above the sinotubular junction and terminating in the left CIA. Extension of the dissection into the brachiocephalic trunk, left CCA and possibly the celiac trunk. The coronary artery origins are normal.

The true lumen (more dense) supplies the celiac trunk, SMA and bilateral renal arteries.

The false lumen (less dense) supplies the IMA.

No renal or splenic infarct but the left kidney density is reduced suggesting reduced perfusion.

Case Discussion

Great example of the possible extent of dissection.

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