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Localized Aortic Root Dissection Detected by Echocardiography: Series of Two Cases

Received: 7 June 2021     Accepted: 21 June 2021     Published: 25 June 2021
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Abstract

Background: Computed Tomography Angiograph (CTA) is the golden standard for diagnosing aortic dissection (AD). However, echocardiography has some advantages over CTA in screening aortic root dissection. Objective: In this report, we present 2 cases of aortic root dissection not found by CTA but by echocardiography. Method: Two middle-aged male patients were admitted to our hospital due to similar symptoms of chest distress. Diastolic murmurs can be heard in the aortic valve second auscultation area. CTA showed aortic artifacts and no dissection signs. The preoperative echocardiography showed that the aortic root was dissected together with aortic valve, and then aortic regurgitation (AR) was formed during diastole. AD was considered. Result: The patients underwent Bentall operation with extracorporeal circulation through femoral arteriovenous cannula. extracorporeal circulation through femoral arteriovenous cannula. The patients were diagnosed as DeBakey type II AD with severe AR during operation. Both of them recovered and were discharged smoothly after the operation. Conclusions: The diagnostic significance of CTA may be limited in some localized aortic root dissections. At this point, we can improve the accuracy of the diagnosis by echocardiography.

Published in Clinical Medicine Research (Volume 10, Issue 3)
DOI 10.11648/j.cmr.20211003.16
Page(s) 102-104
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Aortic Root Dissection, Diagnosis, Echocardiography, Bentall

References
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[2] Bossone E, Ranieri B, Romano L, et al. Acute Aortic Syndromes: Diagnostic and Therapeutic Pathways. Heart Fail Clin. 2020, 16 (3): 305-315.
[3] Zhu Y, Lingala B, Baiocchi M, et al. Type A Aortic Dissection-Experience Over 5 Decades: JACC Historical Breakthroughs in Perspective. J Am Coll Cardiol. 2020, 76 (14): 1703-1713.
[4] Grayburn PA, Thomas JD. Basic Principles of the Echocardiographic Evaluation of Mitral Regurgitation. JACC Cardiovasc Imaging. 2021, 14 (4): 843-853.
[5] Evangelista A, Isselbacher EM, Bossone E, et al. Insights From the International Registry of Acute Aortic Dissection: A 20-Year Experience of Collaborative Clinical Research. Circulation. 2018, 137 (17): 1846-1860.
[6] Ichihashi T, Ito T, Murai S, et al. Acute myocardial infarction due to spontaneous, localized, acute dissection of the sinus of Valsalva detected by intravascular ultrasound and electrocardiogram-gated computed tomography. Heart Vessels. 2016, 31 (9): 1570-1573.
[7] Zhao R, Wu JL, Qiu JT, et al. Overview of multi-center registry of aortic dissection. Zhonghua Wai Ke Za Zhi. 2020, 58 (8): 604-607.
[8] Nienaber CA, Clough RE. Management of acute aortic dissection. Lancet. 2015, 385 (9970): 800-811.
[9] Paulraj S, Kumar PA, Uprety A, et al. Aortic dissection and multimodality imaging. Echocardiography. 2020, 37 (9): 1485-1487.
[10] Kuetting D, Müller A, Feisst A, et al. Incidental Cardiac Findings in Non-Electrocardiogram-gated Thoracic Computed Tomography of Intensive Care Unit Patients: Assessment of Prevalence and Underreporting. J Thorac Imaging. 2018, 33 (3): 168-175.
[11] Morello F, Santoro M, Fargion AT, et al. Diagnosis and management of acute aortic syndromes in the emergency department. Intern Emerg Med. 2021, 16 (1): 171-181.
[12] Luke P, Booth K, Kindawi A, et al. Type A aortic dissection: Why there is still a role for echocardiography when every second counts. SAGE Open Med Case Rep. 2020, 8: 2050313X20973086.
[13] Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/ AHA/ AATS/ ACR/ ASA/ SCA/ SCAI/ SIR/ STS/ SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease. Anesth Analg. 2010, 111 (2): 279-315.
[14] Hoshina R, Kishima H, Mine T, et al. Aortic dissection during transoesophageal echocardiography: a case report. Eur Heart J Case Rep. 2020, 4 (6): 1-5.
[15] Pape LA, Awais M, Woznicki EM, et al. Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection. J Am Coll Cardiol. 2015, 66 (4): 350-358.
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  • APA Style

    Suining Li, Xiaoshen Zhang, Hua Lu, Jiawen Huang. (2021). Localized Aortic Root Dissection Detected by Echocardiography: Series of Two Cases. Clinical Medicine Research, 10(3), 102-104. https://doi.org/10.11648/j.cmr.20211003.16

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    ACS Style

    Suining Li; Xiaoshen Zhang; Hua Lu; Jiawen Huang. Localized Aortic Root Dissection Detected by Echocardiography: Series of Two Cases. Clin. Med. Res. 2021, 10(3), 102-104. doi: 10.11648/j.cmr.20211003.16

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    AMA Style

    Suining Li, Xiaoshen Zhang, Hua Lu, Jiawen Huang. Localized Aortic Root Dissection Detected by Echocardiography: Series of Two Cases. Clin Med Res. 2021;10(3):102-104. doi: 10.11648/j.cmr.20211003.16

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  • @article{10.11648/j.cmr.20211003.16,
      author = {Suining Li and Xiaoshen Zhang and Hua Lu and Jiawen Huang},
      title = {Localized Aortic Root Dissection Detected by Echocardiography: Series of Two Cases},
      journal = {Clinical Medicine Research},
      volume = {10},
      number = {3},
      pages = {102-104},
      doi = {10.11648/j.cmr.20211003.16},
      url = {https://doi.org/10.11648/j.cmr.20211003.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20211003.16},
      abstract = {Background: Computed Tomography Angiograph (CTA) is the golden standard for diagnosing aortic dissection (AD). However, echocardiography has some advantages over CTA in screening aortic root dissection. Objective: In this report, we present 2 cases of aortic root dissection not found by CTA but by echocardiography. Method: Two middle-aged male patients were admitted to our hospital due to similar symptoms of chest distress. Diastolic murmurs can be heard in the aortic valve second auscultation area. CTA showed aortic artifacts and no dissection signs. The preoperative echocardiography showed that the aortic root was dissected together with aortic valve, and then aortic regurgitation (AR) was formed during diastole. AD was considered. Result: The patients underwent Bentall operation with extracorporeal circulation through femoral arteriovenous cannula. extracorporeal circulation through femoral arteriovenous cannula. The patients were diagnosed as DeBakey type II AD with severe AR during operation. Both of them recovered and were discharged smoothly after the operation. Conclusions: The diagnostic significance of CTA may be limited in some localized aortic root dissections. At this point, we can improve the accuracy of the diagnosis by echocardiography.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Localized Aortic Root Dissection Detected by Echocardiography: Series of Two Cases
    AU  - Suining Li
    AU  - Xiaoshen Zhang
    AU  - Hua Lu
    AU  - Jiawen Huang
    Y1  - 2021/06/25
    PY  - 2021
    N1  - https://doi.org/10.11648/j.cmr.20211003.16
    DO  - 10.11648/j.cmr.20211003.16
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 102
    EP  - 104
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20211003.16
    AB  - Background: Computed Tomography Angiograph (CTA) is the golden standard for diagnosing aortic dissection (AD). However, echocardiography has some advantages over CTA in screening aortic root dissection. Objective: In this report, we present 2 cases of aortic root dissection not found by CTA but by echocardiography. Method: Two middle-aged male patients were admitted to our hospital due to similar symptoms of chest distress. Diastolic murmurs can be heard in the aortic valve second auscultation area. CTA showed aortic artifacts and no dissection signs. The preoperative echocardiography showed that the aortic root was dissected together with aortic valve, and then aortic regurgitation (AR) was formed during diastole. AD was considered. Result: The patients underwent Bentall operation with extracorporeal circulation through femoral arteriovenous cannula. extracorporeal circulation through femoral arteriovenous cannula. The patients were diagnosed as DeBakey type II AD with severe AR during operation. Both of them recovered and were discharged smoothly after the operation. Conclusions: The diagnostic significance of CTA may be limited in some localized aortic root dissections. At this point, we can improve the accuracy of the diagnosis by echocardiography.
    VL  - 10
    IS  - 3
    ER  - 

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Author Information
  • Department of Cardiovascular Surgery, First Affiliated Hospital, Jinan University, Guangzhou, China

  • Department of Cardiovascular Surgery, First Affiliated Hospital, Jinan University, Guangzhou, China

  • Department of Cardiovascular Surgery, First Affiliated Hospital, Jinan University, Guangzhou, China

  • Department of Pharmacy, First Affiliated Hospital, Jinan University, Guangzhou, China

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