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Right Heart Failure as an Atypical Presentation of Chronic Type A Aortic Dissection - Multimodality Imaging for Accurate Diagnosis and Treatment. A case report and mini-review of literature

Ioan Tilea

Ioan Tilea

  • George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresTargu Mures, Romania
  • Department of Internal Medicine II- Cardiology II, Emergency Clinical County HospitalTargu Mures, Romania
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Tilea, Ioan
, 
Robert Adrian Dumbrava

Robert Adrian Dumbrava

  • George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresTargu Mures, Romania
  • Department of Internal Medicine II- Cardiology II, Emergency Clinical County HospitalTargu Mures, Romania
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Dumbrava, Robert Adrian
, 
Alexandra Mihaela Ratiu

Alexandra Mihaela Ratiu

  • George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresTargu Mures, Romania
  • Department of Radiology and Medical Imaging, Emergency Clinical County HospitalTargu Mures, Romania
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Ratiu, Alexandra Mihaela
, 
Marius Mihai Harpa

Marius Mihai Harpa

  • George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresTargu Mures, Romania
  • Cardiac Surgery Clinic, The Emergency Institute for Cardiovascular Diseases and TransplantationTargu Mures, Romania
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Harpa, Marius Mihai
, 
Cosmin Marian Banceu

Cosmin Marian Banceu

  • George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresTargu Mures, Romania
  • Cardiac Surgery Clinic, The Emergency Institute for Cardiovascular Diseases and TransplantationTargu Mures, Romania
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Banceu, Cosmin Marian
, 
Dorina Nastasia Petra

Dorina Nastasia Petra

  • George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresTargu Mures, Romania
  • Department of Internal Medicine II- Cardiology II, Emergency Clinical County HospitalTargu Mures, Romania
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Petra, Dorina Nastasia
 and 
Horatiu Suciu

Horatiu Suciu

  • George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu MuresTargu Mures, Romania
  • Cardiac Surgery Clinic, The Emergency Institute for Cardiovascular Diseases and TransplantationTargu Mures, Romania
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Suciu, Horatiu
  
Aug 12, 2022
Right Heart Failure as an Atypical Presentation of Chronic Type A Aortic Dissection - Multimodality Imaging for Accurate Diagnosis and Treatment. A case report and mini-review of literature's Cover Image
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Article Category: Research Article
Published Online: Aug 12, 2022
Page range: 204 - 213
Received: Apr 09, 2022
Accepted: Jun 12, 2022
DOI: https://doi.org/10.2478/jccm-2022-0016
Keywords
© 2022 Ioan Tilea, Robert Adrian Dumbrava, Alexandra Mihaela Ratiu, Marius Mihai Harpa, Cosmin Marian Banceu, Dorina Nastasia Petra, Horatiu Suciu, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Fig. 1

Transthoracic echocardiography examination: (a) the clear presence of the ascending aortic aneurysm (6.87 cm); (b–d) massive pericardial tumoral mass compressing the right atrium. Abbreviations: LA—left atrium; LV—left ventricle; MV—mitral valve; RA—right atrium; RV—right ventricle; SVC—superior vena cava; TV—tricuspid valve; AoV — aortic valve; AscAo — ascending aorta.
Transthoracic echocardiography examination: (a) the clear presence of the ascending aortic aneurysm (6.87 cm); (b–d) massive pericardial tumoral mass compressing the right atrium. Abbreviations: LA—left atrium; LV—left ventricle; MV—mitral valve; RA—right atrium; RV—right ventricle; SVC—superior vena cava; TV—tricuspid valve; AoV — aortic valve; AscAo — ascending aorta.

Fig. 2

Emblematic thoraco-abdominal CT scans. In the coronal and sagittal scans ((a) and (b), respectively), the presence of an ascending aortic aneurysm, hematoma, and compression on RA, SVC, and IVC can be observed. (c) Compression of RA; (d) compression of SVC and RPA (axial CCTA scans). Abbreviations: AscAo—ascending aorta; IVC—inferior vena cava; LV—left ventricle; PA—main pulmonary artery; RA—right atrium; RPA—right pulmonary artery; SVC—superior vena cava.
Emblematic thoraco-abdominal CT scans. In the coronal and sagittal scans ((a) and (b), respectively), the presence of an ascending aortic aneurysm, hematoma, and compression on RA, SVC, and IVC can be observed. (c) Compression of RA; (d) compression of SVC and RPA (axial CCTA scans). Abbreviations: AscAo—ascending aorta; IVC—inferior vena cava; LV—left ventricle; PA—main pulmonary artery; RA—right atrium; RPA—right pulmonary artery; SVC—superior vena cava.

Fig. 3

Intraoperative images. (a) Post-sternotomy, the ascending aortic aneurysm was revealed; (b) the chronic pericardial hematoma; (c) the ascending aorta replaced with a 30 mm-diameter vascular graft; (d) the final result.
Intraoperative images. (a) Post-sternotomy, the ascending aortic aneurysm was revealed; (b) the chronic pericardial hematoma; (c) the ascending aorta replaced with a 30 mm-diameter vascular graft; (d) the final result.
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