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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006963
  • Reminder of important clinical lesson

Aneurysmal dilation of the ascending thoracic aorta and the aortic arch following surgical repair of type A dissection

  1. W Andrew Owens
  1. South Tees Hospitals NHS Foundation Trust, UK
  1. Correspondence to Dr Suzanne Cormack, suzanne.cormack{at}nhs.net

Summary

This report describes the case of a 71-year-old lady who was diagnosed with a Stanford type A dissecting aortic aneurysm which resulted in paraplegia secondary to spinal artery injury at T12 level. She had surgical repair with a tube graft. At a routine review CT scan 2 years postdissection, she presents with asymptomatic but significant dilation, of maximum diameter 78 mm, of the superior part of the ascending thoracic aorta, extending into the arch, suggestive of false aneurysm formation at the surgical anastomoses. There was also thrombosis of the false lumen in the distal arch and descending thoracic aorta. She is a candidate for urgent resection of the aortic arch and reimplantation of the brachiocephalic vessels.

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