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Vol. 56. Issue 3.
Pages 314- (March 2003)
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NOTICE Undefined index: paginaFinal (librerias/utilidadesHtml-cardio.php[88])
Vol. 56. Issue 3.
Pages 314- (March 2003)
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Penetrating Atherosclerotic Ulcer of the Descending Aorta
Úlcera penetrante arteriosclerótica de aorta descendente
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Fernando Hornero Sosa, José A Monteroa, Vicente Cervera Devalb
a Servicio de Cirugía Cardíaca. Hospital General Universitario. Valencia. España.
b Servicio de Radiodiagnóstico. Hospital General Universitario. Valencia. España.
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A sixty-one-year-old man with a history of arterial hypertension went to the emergency room secondary to intense interscapular pain, suggestive of dissection. Physical examination revealed diaphoresis, a systolic arterial pressure of 165 mm Hg, and symmetric peripheral pulses.

Electrocardiogram (ECG) revealed a sinus rhythm with signs of left ventricular hypertrophy. Thoracic computerized tomography (CT) with 3-dimensional reconstruction of the large vessels showed an adventitial hematoma of the proximal third of the descending thoracic aorta with a 16×10 mm sacular penetrating ulcer on the anterior face. Imaging of an endoluminal dissection showed the diameter of the thoracic aorta to be 33 mm (Figure 1). During surgery external examination revealed a thoracic aorta with a subadventitial hematoma in the upper half; resection of approximately 6 cm of the aortic portion was performed and replacement was made with a Dacron prosthesis. The excised portion revealed an atherosclerotic aorta with a hematoma on the wall and an opening on the endothelial wall corresponding to a sacular pseudoaneurysm. This was associated with multiple ulcerations on the remainder of the aortic wall (Figure 2).

Fig. 1

Fig. 2.

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Revista Española de Cardiología (English Edition)

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