Type A aortic dissection extending into left main coronary artery
Presentation
Known thoracic aortic dissection.
Patient Data
Type A aortic dissection with dissection flap involving dilated aortic root with extension into the left main coronary artery (LMCA). The brachiocephalic, left common carotid, and left subclavian artery are patent.
Chronic type B aortic dissection unchanged compared to prior CT (not shown).
Left lower lobe bronchus mucoid impaction with near complete atelectasis/consolidation of the left lower lobe. Minimal tree-in-bud nodularity within the left upper lobe.
Case Discussion
Type A aortic dissections are prone to multiple life threatening complications, including rupture into the pericardium, proximal propagation with aortic valve dysfunction and propagation into branch vessels with subsequent ischemia. This is an example of propagation into the left main coronary artery. The right coronary artery is involved more often than the left.
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