A Diagnostic Conundrum in a Localized Ascending Aortic Aneurysm

  • Affirul Chairil Ariffin Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
  • Hanizah Ngadiron Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
  • Firdaus Hayati
  • Nornazirah Azizan Department of Pathobiology and Medical Diagnostic, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia
  • Fairrul Kadir Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia
  • Andee Dzulkarnaen Zakaria Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
Keywords: Saccular, aneurysm, aortic dissection, goretex, graft

Abstract

Aortic dissection (AD) is an uncommon life-threatening emergency. Its development is usually subtle and easily missed. On the other hand, an aneurysm nearly always requires immediate surgical intervention. Both interventions are technically different and pose their own challenges. We experienced a distinct case of AD of the ascending aorta in a 65-year-old lady, who presented with a sudden onset of severe chest pain and shortness of breath. Thoracic aortic aneurysm was suspected as computed tomography revealed a saccular aneurysm of the proximal ascending aorta with no involvement of the valve and aortic branches. Surgery was decided after considering the risk of rupture and mortality. However, a diagnosis of localized aortic dissection was discovered and repaired accordingly. We discuss the pitfalls of diagnostic modalities and the techniques of surgical repair.

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Published
2018-09-22