Type A aortic dissection

Case contributed by Dr Muthu Magesh

Presentation

Sudden acute flaccid paralysis.

Patient Data

Age: 20 years
Gender: Male
CT

Dilatation of aortic root with aortic dissection involving the entire aorta with intimal flap extending into right brachiocephalic trunk, origin of right subclavian & right common carotid artery and distally into the origin of left common iliac artery (DeBakey type I/Stanford type A)

Multiple peripheral linear hypodensities are seen in the cortex of left kidney likely infarcts.

 Areas of consolidation are seen in the dependent parts of both lower lobes s/o aspiration pneumonia.

Case Discussion

The patient with tall stature and a long arm span presented to the ER with acute flaccid paralysis. Echo was performed and the free moving flap was seen, hence the patient was immediately taken for CT aortogram and diagnosis of aortic dissection and type was established.

The Stanford system classification system was used to differentiate types of aortic dissection:

  • Aortic dissection involving the ascending aorta is Stanford type A which needs surgical repair by replacing the aortic root with a composite graft, also known as Bentall procedure.
  • Aortic dissection involving the distal part of the aortic arch is Stanford type B which needs medical treatment for reducing blood pressure.

The patient was referred to a tertiary center for further treatment.

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Case information

rID: 74545
Published: 19th Jun 2020
Last edited: 19th Jun 2020
System: Vascular
Inclusion in quiz mode: Included

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