Proximal Aortic Dissection with Rupture into the Main Pulmonary Artery

Aim: To present a rare occurrence of aortopulmonary fistula due to rupture of proximal aortic dissection in a 48-year old woman. Introduction: Aortic dissection is defined as disruption of the medial layer provoked by intramural bleeding, resulting in separation of aortic wall layers and subsequent formation of a true lumen and a false lumen with or without communication. Discussion: The etiology of aortic dissection include mostly hypertension in 80 % of cases and aortopathies such as connective tissue disorders, inflammatory and sometimes idiopathic. Aortic wall stress is a major trigger of intimal tear and two-dimensional transthoracic echocardiography is an excellent, initial diagnostic gold standard to detect the dissecting flaps, especially in proximal aortic dissection. Conclusion: Blood pressure control is the mainstay of treatment and urgent surgery is indicated in proximal aortic dissection since there is higher chance of rupture with an increase in mortality.

Autorentext

Dr. Ramachandran Muthiah, MBBS, MD, DM, FNB, ACCF.Presidente di tutte le nazioniMedico e cardiologo Morning Star Hospital, Marthandam, distretto di Kanyakumari, India.