Department of Cardiac Surgery, The Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
Department of Cardiology, Gloucester Royal Hospital, Gloucester, UK.
J Card Surg. 2021 Sep;36(9):3417-3420. doi: 10.1111/jocs.15714. Epub 2021 Jun 1.
A subtle aortic dissection can be challenging to detect despite the availability of multiple diagnostic modalities. Whilst rare, the inability to detect this variant of aortic dissection can lead to a dismal prognosis. We present an extremely rare case of a subtle aortic dissection with supra-annular aortic root intimal tear and acute severe aortic regurgitation in a patient with a bicuspid aortic valve.
Case report and literature review conserning subtle aortic dissection is provided.
Initial concerns were either aortic dissection or infective endocarditis. Despite advanced multimodality preoperative imaging, diagnosis was made intraoperatively and a Bentall procedure with a mechanical aortic valve was performed.
Our case along with the review of current literature emphasizes that current imaging techniques may be inadequate for diagnosis of this rare variant of aortic dissection.
尽管有多种诊断方法，但对于细微的主动脉夹层仍难以检测。尽管罕见，但无法检测到这种变体的主动脉夹层可能导致预后不佳。我们报告了一例极其罕见的伴有瓣上主动脉根部内皮层撕裂和急性严重主动脉瓣反流的二叶式主动脉瓣细微主动脉夹层病例。
提供了关于细微主动脉夹层的病例报告和文献复习。
最初的担忧是主动脉夹层或感染性心内膜炎。尽管进行了先进的多模态术前影像学检查，但术中诊断为主动脉夹层，并进行了 Bentall 手术和机械主动脉瓣置换术。
我们的病例以及对当前文献的回顾强调，目前的成像技术可能不足以诊断这种罕见的主动脉夹层变体。
