Subscribe to RSS
DOI: 10.1055/s-2008-1039110
© Georg Thieme Verlag KG Stuttgart · New York
Contained Rupture of the Aorta in Acute Stanford Type A Aortic Dissection Causing Right Ventricular Wall Dissection
Publication History
received June 10, 2008
Publication Date:
20 May 2009 (online)

Abstract
We describe a rare case of an acute aortic type A dissection after previous aortic valve replacement and coronary artery revascularization complicated by a contained rupture and right ventricular wall dissection. Although preoperatively echocardiography and CT scan described a pericardial hematoma, intraoperatively no intrapericardial hematoma was found; instead an extended right ventricular wall dissection caused by a large thrombus formation within the right ventricular muscle layers was demonstrated. After replacement of the ascending aorta and removal of the thrombus as the sole treatment for right ventricular wall dissection, the two dissected layers of the right ventricular wall were contracting synchronously again.
Key words
Aortic disease - contained rupture - ventricular wall dissection
References
- 1 Yaimaci B, Bozbuga N, Balkanay M. Unruptured left ventricular pseudoaneurysm. Int J Cardiol. 2001; 77 99-101
- 2 Soriano C J, Pérez-Boscá J L, Canovas S, Ridocci F, Federico P, Echanove I, Paya R. Septal rupture with right ventricular wall dissection after myocardial infarction. Cardiovasc Ultrasound. 2005; 3 33
- 3 Gradaus F, Heintzen M P, Peters A J, Perings C, Winter J, Strauer B-E. Großes Pseudoaneurysma des linken Ventrikels nach Posterolateralwandinfarkt. Z Kardiol. 1999; 88 29-33
- 4 Kaul P. Repeated successful surgical rescues of early and delayed multiple ruptures of ventricular septum, right ventricle and aneurysmal left ventricle following massive biventricular infarction. J Cardiothorac Surg. 2006; 1 30
- 5 Stanger O, Oberwalder P, Dacar D, Knez I, Rigler B. Late dissection of the ascending aorta after previous cardiac surgery: risk presentation and outcome. Eur J Cardiothorac Surg. 2002; 21 453-458
- 6 Verna E, Repetto S, Saveri C, Forgioni N, Merchant S, Binaghi G. Myocardial dissection following successful chemical ablation of ventricular tachycardia. Euro Heart J. 1992; 13 844-846
- 7 Galrinho A, Loureiro J, Magalhäes M P. Intramyocardial dissection with rupture of the right ventricle after an acute myocardial infarction – a rare complication diagnosed by transesophageal echocardiography. Eur J Echocardiography. 2003; 4 152-153
- 8 Frank M W, Stout M J. Acute aortic dissection with an aorta-right atrium fistula. Tex Heart Inst J. 2003; 30 335-336
Dr. Jörg Babin-Ebell
Cardiovascular Clinic Bad Neustadt
Salzburger Leite 1
97616 Bad Neustadt/Saale
Germany
Phone: + 49 (0) 97 71 66 24 16
Fax: + 49 (0) 97 71 65 12 21
Email: joerg.babin-ebell@web.de