Cover Image: Spontaneously healed type A aortic dissection
Anitha Varghese1, Neil Moat2, and Raad H. Mohiaddin1
1Cardiovascular Magnetic Resonance Unit, Royal Brompton and Harefield NHS Trust, London, UK
2Department of Cardiothoracic Surgery, Royal Brompton Hospital and Harefield NHS Trust, London, UK
A 57-year-old man presented with a 5-day history of breathlessness, weakness, and headaches followed by collapse. He had signs and symptoms of shock and the right and left arm blood pressures were equal. Blood gases revealed a decompensated metabolic acidosis and troponin was positive. The computed tomographic head scan was normal. Sinus tachycardia was noted on 12-lead electrocardiography and transthoracic echocardiography suggested widening of the aortic root without aortic regurgitation. Type A aortic dissection was demonstrated by transoesophageal echocardiography. Multi-organ failure and disseminated intravascular coagulopathy precluded emergency surgery. Initial cardiovascular magnetic resonance (CMR) confirmed a type A aortic dissection from the sinotubular junction (Panel A) to the left common iliac artery (Panel C). Cine-imaging of the aorta showed slow flow and laminated thrombus within the ascending dissection, and repeat CMR 1 year later revealed a rare spontaneously healed dissection in this region (Panels B and D) while the dissection in the transverse arch, descending thoracic aorta, abdominal aorta, and left common iliac artery remained unchanged (Panel C).
Figure legend:
Healed aortic dissection.
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