Aortic Dissection

Henry C. Veldenz
University of Florida Health Science Center
Jacksonville, FL

Brief Case History

This is a 38-year-old white woman with a significant history of Marfan's in her family. Her mother and older sister both have had repairs in the past. She now presents with pain and a history of a new dissection in her chest three weeks prior, confirmed by CT (See Figure 1) and arteriogram (See Figure 2). Concern for continued expansion prompted the operation. She underwent a successful thoraco-abdominal Dacron graft replacement and re-implantation of visceral arteries. At surgery, the intramural hematoma was seen (See Figure 3).

Figure 1: CT scan of aorta at the level of the superior mesenteric artery. The arrow points to the 'septum' of the dissection.

Figure 2: Arteriogram of abdominal aorta showing the two lumens.

Figure 3: Intra-operative picture of thoraco-abdominal aorta showing the left subclavian artery (white arrow), the SMA and Celiac axis (blue loops), and the intramural hematoma of the dissection (black arrow).

Society for Vascular Surgery - 633 N. St. Clair, 24th Floor; Chicago, IL 60611; Phone: 312-334-2300 or 800-258-7188; Fax: 312-334-2320; Email: vascular@vascularsociety.org
© 2010 VascularWeb. All rights reserved. Use of the VascularWeb site constitutes acceptance of all of the policies, rules and regulations for the site.