ABSTRACT
Ascending thoracic aortic aneurysms are rare in childhood and typically are seen in the setting of connective tissue defect syndromes. These aneurysms may lead to rupture, dissection, or valvular insufficiency, so root replacement is recommended. Here, we present a 17-month-old girl who presented with fever, cough, and pericardial effusion. Initially, we suspected this could be a COVID-19 case, so a nasopharyngeal swap was performed. An ascending aorta aneurysm involving the aortic arch was confirmed by echo, and urgent ascending aorta and arch replacement were done by utilizing the descending aorta as a new arch. The final diagnosis came with cutis laxa syndrome. In similar cases, good outcomes can be achieved with accurate diagnosis and appropriate surgical management.
Subject(s)
Aorta, Thoracic/surgery , Aortic Aneurysm/complications , Aortic Aneurysm/surgery , Cutis Laxa/complications , Aortic Aneurysm/diagnostic imaging , COVID-19/diagnosis , Cough/etiology , Diagnosis, Differential , Echocardiography , Female , Fever/etiology , Humans , Infant , Pericardial Effusion/etiology , Radiography, Thoracic , SARS-CoV-2 , SyndromeABSTRACT
Acute aortic dissection and acute pulmonary embolism (PE) are life-threatening emergencies that can mimic each other at presentation. Immediate and accurate diagnosis of these scenarios is crucial to initiate the appropriate interventions. In this case report we present a 73-year-old patient, who was admitted to our Medical Center with acute type A aortic dissection. She was tested for coronavirus disease 2019 (COVID-19) infection and was found to be positive. During her admission in the COVID-19 designated intensive care unit, she diagnosed with acute PE in the main right and left pulmonary arteries. She underwent surgery that included bilateral pulmonary embolectomy and aortic dissection repair. The patient was discharged from our hospital on the ninth postoperative day without any complications. Frequency of simultaneous presentation of acute aortic dissection and acute PE is increased with a history of coagulation abnormalities as seen in patients with COVID-19.
Subject(s)
Aortic Aneurysm/surgery , Aortic Dissection/surgery , COVID-19/diagnosis , Aged , Aortic Dissection/diagnostic imaging , Aortic Aneurysm/diagnostic imaging , Computed Tomography Angiography , Embolectomy , Female , Humans , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/surgeryABSTRACT
BACKGROUND: In acute aortic dissection, various findings can be found in computed tomography. However, pulmonary infiltration is rarely observed. CASE REPORT: A 57-year-old man was diagnosed with acute aortic dissection (AAD), but had marked infiltration shadows in his right lung. Intraoperative findings showed that large subadventitial hematomas had spread from the ascending aorta to the right pulmonary artery, which may have caused the infiltration of the lung. CONCLUSIONS: Subadventitial hematoma must be considered in rare cases of AAD with pulmonary infiltration.