Aortic dissection—Pulmonary embolism association: A therapeutic dilemma

Tiemtoré-Kambou, Benilde Marie-Ange; Koama, Adjirata; Kontogom, Solange; Zabsonré/Tiendrébéogo, Joelle; Bayala, Donald; Ndé/Ouédraogo, Nina Astrid; Zanga, Moussa; Napon, Aïscha Madina; Diallo, O.; Lougue-Sorgho, Claudine; Cissé, Rabiou

doi:10.1016/j.radcr.2022.04.045

Cited by 1 publication

(2 citation statements)

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“…PAA is a rare diagnosis with an incidence of 1:14000, and co-occurrence of PE and aortic dissection is rather exceptional [1]. Considering the reported prevalence of 0.6% of all saccular aortic aneurysms occurring in the ascending aorta, simultaneous diagnosis of PAA with PAH and secondary PE, and a saccular, post-dissection TAA of the ascending aorta has not yet been described [3,5].…”

Section: Discussionmentioning

confidence: 99%

“…We report on a case of large PAA of the pulmonary trunk and main pulmonary arteries secondary to PAH, coincided by the diagnosis of secondary thromboembolism of the left PAA and a post-dissection saccular aneurysm of the ascending aorta (TAA). To our knowledge, a few cases have been reported on the simultaneous occurrence of PAA, PE and TAA [ 3 , 4 ]. However, the combination of a large PAA of this caliber, with secondary PE and a saccular TAA of the ascending aorta has not yet been described.…”

Section: Introductionmentioning

confidence: 99%

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A rare case of a simultaneous post-dissection saccular aneurysm of the ascending aorta and large pulmonary artery aneurysm with secondary embolism: a case report

van Dinter,

Arslan,

Boerman

et al. 2024

J Cardiothorac Surg

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Background Aneurysms of the pulmonary arteries and the ascending aorta are rare, and both bear a high mortality risk if left untreated. In general, these entities are primarily caused by etiologies such as hypertension, pulmonary arterial hypertension, infection or congenital disorders. Treatment requires a rapid diagnostic work-up or even immediate surgical intervention in acute cases. Nevertheless, surgery entails serious perioperative risks, in particular in patients with multiple comorbidities. Case presentation We discuss a 70-year-old woman presented with decompensated heart failure based on severe pulmonary artery hypertension, coincided by a massive pulmonary artery aneurysm with secondary embolism. Additional diagnostic imaging also showed a chronic post-dissection, saccular aneurysm of the ascending aorta. To our knowledge, this simultaneous diagnosis of a saccular aneurysm of the ascending aorta and a large aneurysm of the pulmonary artery with secondary embolism has not yet been described. Nonetheless, conservative treatment was chosen due to extensive pulmonal and cardiovascular comorbidities and the high-risk profile of surgery. Conclusions Extensive aneurysmatic disease of the pulmonary arteries and ascending aorta come with a serious burden of disease, especially if coincided by severe pulmonal and cardiovascular comorbidities. Both conditions can be curatively treated by surgical intervention. However, in every case the risk of surgery and the patient’s vitality, comorbidities and wishes should be taken into account to formulate an adequate treatment plan. Therefore, shared decision making is of utter importance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%