Department of Cardiology, Nemazee Hospital, Shiraz University of Medical Sciences, Nemazee Square, Shiraz, 71936-13311, Iran.
Department of Cardiac Surgery, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
BMC Cardiovasc Disord. 2022 Jun 6;22(1):254. doi: 10.1186/s12872-022-02687-6.
Thoracic aortic aneurysm (TAA), is a pathological dilatation of the aortic segment with the tendency to expand, dissect or rupture, and risk of mortality. The progression rate is mainly slow. As the risk of rupture increases with the size of the aortic diameter, it is important to diagnose TAA appropriately to prevent mortality.
Here, we present a case with a fast-growing TAA, complicated by subclinical dissection in a middle-aged gentleman, associated with non-compaction left ventricle, diagnosed 6 months after the first diagnosis of this co-occurrence, successfully managed by an uneventful surgical procedure. The pathological examination was the key to the diagnosis of this concealed phenomenon, i.e. a fast-growing aortic aneurysm complicated by subclinical dissection.
This case report emphasizes the importance of close follow-up of patients with fast-growing TAA for considering remote possibility of this silent life-threatening disease; subclinical dissecting aneurysm, especially in patients with other cardiac comorbidities. Although imaging modalities can help accurate diagnosis, in cases with fast-growing TAA, we should not wait for imaging signs of dissection and/or rupture.
胸主动脉瘤（TAA）是主动脉节段病理性扩张的一种疾病，具有扩张、夹层或破裂的倾向，存在死亡风险。进展速度主要较慢。由于主动脉直径越大，破裂的风险越高，因此适当诊断 TAA 以预防死亡率非常重要。
在此，我们介绍了一例中年男性快速生长的 TAA 合并亚临床夹层的病例，同时还伴有左心室非致密化，在首次诊断出这一并存疾病 6 个月后被确诊，手术过程顺利。病理检查是诊断这种隐匿性现象的关键，即快速生长的主动脉瘤合并亚临床夹层。
本病例报告强调了对快速生长的 TAA 患者进行密切随访的重要性，以考虑这种沉默的危及生命的疾病（亚临床夹层动脉瘤）的可能性；特别是在有其他心脏合并症的患者中。虽然影像学方法有助于准确诊断，但对于快速生长的 TAA 患者，我们不应该等待出现夹层和/或破裂的影像学征象。
