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Int J Angiol 2021; 30(02): 160-164
DOI: 10.1055/s-0040-1718546
Case Report

Aortic Delamination—A Possible Precursor of Impending Catastrophe

Ayman Saeyeldin
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut
2   Department of Internal Medicine, Saint Mary's Hospital, Waterbury, Connecticut
,
Mohammad A. Zafar
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut
,
Lauren A. Baldassarre
3   Department of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut
4   Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
,
Hamid Mojibian
4   Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
,
Bulat A. Ziganshin
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut
5   Department of Surgical Diseases #2, Kazan State Medical University, Kazan, Russia
,
Sandip K. Mukherjee
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut
3   Department of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut
,
John A. Elefteriades
1   Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut
› Author Affiliations Source of Funding None.
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Abstract

Aortic diameter is a powerful predictor of adverse aortic events, such as aortic rupture or dissection, forming the basis of prophylactic surgical repair criteria. Limited evidence is available regarding the association of aortic wall thickness (AWT) with these adverse aortic events. We present the case and surgical video of a 73-year-old man with chest pain and an increased AWT, who underwent ascending aortic repair and deep hemiarch placement under deep hypothermic circulatory arrest. Surgical pathology demonstrated evidence of aortic delamination and medial separation, indicative of an impending dissection. The patient recovered uneventfully, and his chest pain ultimately resolved after open repair. In this patient, increased AWT was felt to be the precursor to a potential aortic catastrophe.

Keywords

ascending aorta - aortic wall thickness - dissection - rupture - delamination

Disclosures

None relevant to the current report. Dr. John Elefteriades sits on the Data and Safety Monitoring Boards of Terumo and Jarvik Heart and is a principal of CoolSpine. The other authors have nothing to disclose.




Publication History

Article published online:
11 March 2021

© 2021. International College of Angiology. This article is published by Thieme.

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