https://doi.org/10.4081/monaldi.2024.2986
An incidental finding of localized aortic arch dissection in a polytraumatized patient. A case report and state of the art of non-A non-B aortic dissection
Submitted: March 10, 2024
Accepted: June 22, 2024
Published: September 12, 2024
Accepted: June 22, 2024
Abstract Views: 129
PDF_EARLY VIEW: 54
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Non-A non-B aortic dissection is considered a rare nosological entity, included in the Stanford classification, representing a small percentage of the total aortic dissections that occur annually. Regarding this form, the literature reports a more complicated disease course compared to other types of dissection. We describe the case of a 76-year-old patient who accessed the triage section of an emergency department for a polytrauma picture and, after surgical treatment of a leg fracture, received a diagnosis of non-A non-B aortic dissection, "localized" to the arch and incidentally detected. The angio-computed tomography (CT) showed that the only intimal tear was located in the central portion of the aortic arch, with no exit tear. No signs of malperfusion or clinical symptoms related to the aortic finding were evident. The Aortic Team decided on a conservative approach, whereby the patient was started on medical therapy to control blood pressure in a monitored bed of a semi-intensive care unit. The persistent asymptomatic state, a condition of hemodynamic stability, and an unchanged angio-CT picture enabled discharge on day 7 and the assignment to a close follow-up.
Sievers HH, Rylski B, Czerny M, et al. Aortic dissection reconsidered: type, entry site, malperfusion classification adding clarity and enabling outcome prediction. Interact Cardiovasc Thorac Surg 2020;30:451-7.
DOI: https://doi.org/10.1093/icvts/ivz281
Di Marco L, Di Carlo M, Murana G, et al. Management of acute type B aortic dissection: treatment and follow-up. G Ital Cardiol 2023;24:731-9.
Koechlin L, Schuerpf J, Bremerich J, et al. Acute aortic dissection with entry tear at the aortic arch: long-term outcome. Interact Cardiovasc Thorac Surg 2021;32:89-96.
DOI: https://doi.org/10.1093/icvts/ivaa228
Von segesser LK. Operative anatomy of the arch. Eur J Cardiothorac Surg 2012;42:201-2.
DOI: https://doi.org/10.1093/ejcts/ezs262
Howard C, Ponnapalli A, Shaikh S, et al. Non-A non-B aortic dissection: a literature review. J Card Surg 2021;36:1806-13.
DOI: https://doi.org/10.1111/jocs.15349
Urbanskia PP, Wagner M. Acute non-A-non-B aortic dissection: surgical or conservative approach?. Eur J Cardiothorac Surg 2016;49:1249-54.
DOI: https://doi.org/10.1093/ejcts/ezv301
Erbel R, Aboyans V, Boileau C, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases. Eur Heart J 2014;35:2873-926.
DOI: https://doi.org/10.1093/eurheartj/ehu281
Czerny M, Schmidli J, Adler S, et al. Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association for Cardio-Thoracic surgery (EACTS) and the European Society for Vascular Surgery (ESVS). Eur J Cardiothorac Surg 2019;55:133-62.
DOI: https://doi.org/10.1093/ejcts/ezy383
Isselbacher EM, Preventza O, Black JH, et al. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease. J Am Coll Cardiol 2022;80:e223-393.
DOI: https://doi.org/10.1016/j.jacc.2022.08.004
Rylski B, Pérez M, Beyersdorf F, et al. Acute non-A non-B aortic dissection: incidence, treatment and outcome. Eur J Cardiothorac Surg 2017;52:1111-7.
DOI: https://doi.org/10.1093/ejcts/ezx142
Ethics Approval
The authors obtained ethics approval from the Hospital Ethic Committee for the case publication (doc. N. 7/24).How to Cite
Parato, Andrea Giovanni, Simone D’Agostino, Simona Pelliccioni, Maria Virginia Boni, Andrea Angelini, Francesco Sbaraglia, and Vito Maurizio Parato. 2024. “An Incidental Finding of Localized Aortic Arch Dissection in a Polytraumatized Patient. A Case Report and State of the Art of <i>non-A Non-B< i> Aortic Dissection”. Monaldi Archives for Chest Disease, September. https://doi.org/10.4081/monaldi.2024.2986.
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Giovanni Rossi, Mario Perrillo, Martina Flora, Adriano Costigliola, Mariano Mollica, Carlo Iadevaia, Giampiero Gaio, Francesco S. Cerqua, Andrea Bianco, Fabio Perrotta, Incidental diagnosis and therapeutic approach of an iatrogenic intra-parenchymal pulmonary intercostal artery pseudoaneurysm: a case report , Monaldi Archives for Chest Disease: Vol. 89 No. 3 (2019)
- Genki Inui, Katsuyuki Tomita, Masaharu Fukuki, Hirokazu Touge, Tomoyuki Ikeuchi, Ichiro Hisatome, Akira Yamasaki, Clinical characteristics for distinguishing between acute cardiogenic pulmonary edema and community-acquired pneumonia in elderly patients: a prospective observational study , Monaldi Archives for Chest Disease: Vol. 94 No. 2 (2024)
- Mario Tamburrini, Dipesh Maskey, Nirupam Sharan, T.K. Jayalakshmi, Umberto Zuccon, Giuseppe Deda, Convex probe endobronchial ultrasound guided transbronchial/transoesophageal fine needle aspiration (C-EBUS-TBNA/EUS-B FNA) of pleural lesions: A single center experience and review of literature , Monaldi Archives for Chest Disease: Vol. 90 No. 3 (2020)
- Gaia Cipolla, Rosalba Relo, Elisa Pasciuta, Domenica Catalano, Federica Lo Bello, Irene Coppolino, Paolo Ruggeri, Alfio Proietto, Maria Buccafusca, Paola Maria Cutroneo, Gianluca Trifirò, Gaetano Caramori, A case of lung injury resembling diffuse pulmonary hemorrhage after the first administration of alemtuzumab in a patient with multiple sclerosis. Role of the HRCT , Monaldi Archives for Chest Disease: Vol. 90 No. 3 (2020)
- Matteo Pernigo, Elisabetta Dinatolo, Marco Cirillo, Zean Mhagna, Alida Filippini, Fabiana Cozza, Marco Berti, Roberto Bazzani, Tony Sabatini, Claudio Cuccia, Giovanni Troise, Finger ischemia in a young lady: an unusual presentation of papillary fibroelastoma with intraventricular location , Monaldi Archives for Chest Disease: Vol. 94 No. 1 (2024)
- Giorgio E. Polistina, Francesca Simioli, Pasquale Imitazione, Maurizia Lanza, Anna Annunziata, Giuseppe Fiorentino, Different presentation of pulmonary parenchymal disruption in COVID-19 pneumonia. Case series of Sub-Intensive Care Unit in Naples, Italy , Monaldi Archives for Chest Disease: Vol. 90 No. 4 (2020)
- Nitin Goel, Nitesh Goyal, Raj Kumar, Exertional dyspnea and hemoptysis in an adolescent: is it tuberculosis only? , Monaldi Archives for Chest Disease: Vol. 91 No. 1 (2021)
- Mehul Agarwal, Manohar Lal Gupta, Kunal Deokar, Benhur Joel Shadrach, Neha Bharti, Maldev Sonigra, Clinico-radiological profile of connective tissue disease related-interstitial lung diseases from a tertiary care centre of India: a cross sectional study , Monaldi Archives for Chest Disease: Vol. 91 No. 4 (2021)
- Shivam Garg, Pratap Upadhya, Arul Kumar, Norton Stephen, Bala Subramanian, Overcoming the challenges of a misdiagnosed rare lung disease – idiopathic pleuroparenchymal fibroelastosis , Monaldi Archives for Chest Disease: Vol. 94 No. 2 (2024)
- Cuneyt Tetikkurt, Zeynep Ferhan Ozseker, Fatma Gülsüm Karakaş, Splenic artery aneurysm in Sjögren’s syndrome , Monaldi Archives for Chest Disease: Vol. 89 No. 2 (2019)
<< < 7 8 9 10 11 12 13 14 15 16 > >>
You may also start an advanced similarity search for this article.
