Mehrpooya Maryam, Salehi Mehrdad, Eskandari Ramin, Shajirat Zeinab, Golabchi Allahyar, Mazoochi Majid
Assistant Professor, Department of Cardiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical.
ARYA Atheroscler. 2012 Fall;8(3):167-9.
In true aneurysm, the wall of aneurysm is composed of the normal histological components of aorta. A false aneurysm (pseudoaneurysm) represents a rupture which does not contain the normal histological components of aorta. It is a fibrous peel that has formed from a small perforation of aorta. We describe an unusual presentation that has signs which some of them are only manifested in true aneurysm and some others only in pseudoaneurysm.
An 85-year-old man underwent elective coronary angiography for chest pain work-up. Our evaluation by invasive angiography and CT angiography showed aortic dissection. In surgery we found that dissection flap was composed of some parts of intima and media layers. These signs leaded to confusing symptoms. Localized bulging of ascending aorta had continued to brachiocephalic artery (transverse arch involvement). Dissection flap was composed of some part of intima and media layers. It was a strange case, it was not solely a perivascular hematoma and it did not have all three layers of aorta wall. Partial aorta replacement was performed. The operation and recovery was uneventful.
This unusual presentation of disease has not been mentioned in literatures. Our experience can help to manage similar cases. This case was the first unusual presentation of its type.
在真性动脉瘤中，动脉瘤壁由主动脉的正常组织学成分组成。假性动脉瘤是指主动脉破裂但不包含主动脉正常组织学成分的情况。它是由主动脉的小穿孔形成的纤维包膜。我们描述了一种不寻常的表现，其一些体征仅在真性动脉瘤中出现，而另一些仅在假性动脉瘤中出现。
一名85岁男性因胸痛接受选择性冠状动脉造影检查。我们通过有创血管造影和CT血管造影评估显示主动脉夹层。手术中我们发现夹层瓣由内膜和中膜层的一些部分组成。这些体征导致了令人困惑的症状。升主动脉局部膨出延伸至头臂动脉（累及横弓）。夹层瓣由内膜和中膜层的一些部分组成。这是一个奇怪的病例，它不仅仅是血管周围血肿，也不具备主动脉壁的所有三层结构。进行了部分主动脉置换术。手术和恢复过程顺利。
文献中未提及这种疾病的不寻常表现。我们的经验有助于处理类似病例。该病例是其类型中的首例不寻常表现。
