array:25 [
  "pii" => "S2174204913002031"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2013.10.035"
  "estado" => "S300"
  "fechaPublicacion" => "2013-09-01"
  "aid" => "316"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2013"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "sco"
  "cita" => "Rev Port Cardiol. 2013;32:737-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4131
    "formatos" => array:3 [
      "EPUB" => 161
      "HTML" => 3249
      "PDF" => 721
    ]
  ]
  "Traduccion" => array:1 [
    "pt" => array:20 [
      "pii" => "S0870255113001637"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2013.04.003"
      "estado" => "S300"
      "fechaPublicacion" => "2013-09-01"
      "aid" => "316"
      "copyright" => "Sociedade Portuguesa de Cardiologia"
      "documento" => "article"
      "crossmark" => 0
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "sco"
      "cita" => "Rev Port Cardiol. 2013;32:737-9"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 5183
        "formatos" => array:3 [
          "EPUB" => 188
          "HTML" => 3960
          "PDF" => 1035
        ]
      ]
      "pt" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Imagem em Cardiologia</span>"
        "titulo" => "Dissec&#231;&#227;o a&#243;rtica tipo A aguda corrigida&#58; caso encerrado&#63;"
        "tienePdf" => "pt"
        "tieneTextoCompleto" => "pt"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "737"
            "paginaFinal" => "739"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Repaired acute type A aortic dissection&#58; End of case&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "pt" => true
        ]
        "contienePdf" => array:1 [
          "pt" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0015"
            "etiqueta" => "Figura 3"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr3.jpeg"
                "Alto" => 1002
                "Ancho" => 2167
                "Tamanyo" => 233813
              ]
            ]
            "descripcion" => array:1 [
              "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Angio-TC tor&#225;cica&#58; visualiza-se sa&#237;da de contraste &#40;losango vermelho&#41; por fuga distal no tubo de Dacron &#40;losango vermelho&#41; &#8211; <span class="elsevierStyleItalic">Endoleak</span> tipo <span class="elsevierStyleSmallCaps">I</span>&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Francisca Caetano, Andreia Fernandes, Joana Trigo, Susana Basso, Ana Botelho, Ant&#243;nio Leit&#227;o Marques"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Francisca"
                "apellidos" => "Caetano"
              ]
              1 => array:2 [
                "nombre" => "Andreia"
                "apellidos" => "Fernandes"
              ]
              2 => array:2 [
                "nombre" => "Joana"
                "apellidos" => "Trigo"
              ]
              3 => array:2 [
                "nombre" => "Susana"
                "apellidos" => "Basso"
              ]
              4 => array:2 [
                "nombre" => "Ana"
                "apellidos" => "Botelho"
              ]
              5 => array:2 [
                "nombre" => "Ant&#243;nio"
                "apellidos" => "Leit&#227;o Marques"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "pt"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2174204913002031"
          "doi" => "10.1016/j.repce.2013.10.035"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204913002031?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255113001637?idApp=UINPBA00004E"
      "url" => "/08702551/0000003200000009/v1_201309260109/S0870255113001637/v1_201309260109/pt/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2174204913002511"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2012.12.006"
    "estado" => "S300"
    "fechaPublicacion" => "2013-09-01"
    "aid" => "326"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Rev Port Cardiol. 2013;32:741"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2494
      "formatos" => array:3 [
        "EPUB" => 143
        "HTML" => 1816
        "PDF" => 535
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Prevalence of hypertension in Portuguese adolescents"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "741"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Preval&#234;ncia de hipertens&#227;o em adolescentes portugueses"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Sait Demirkol, Omer Kurt, Sevket Balta, Mustafa Cakar"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Sait"
              "apellidos" => "Demirkol"
            ]
            1 => array:2 [
              "nombre" => "Omer"
              "apellidos" => "Kurt"
            ]
            2 => array:2 [
              "nombre" => "Sevket"
              "apellidos" => "Balta"
            ]
            3 => array:2 [
              "nombre" => "Mustafa"
              "apellidos" => "Cakar"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204913002511?idApp=UINPBA00004E"
    "url" => "/21742049/0000003200000009/v1_201312060118/S2174204913002511/v1_201312060118/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S217420491300250X"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2013.02.018"
    "estado" => "S300"
    "fechaPublicacion" => "2013-09-01"
    "aid" => "328"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Cardiol. 2013;32:735-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2982
      "formatos" => array:3 [
        "EPUB" => 161
        "HTML" => 2327
        "PDF" => 494
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
      "titulo" => "Long-term survival in a patient with single ventricle"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "735"
          "paginaFinal" => "736"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Sobreviv&#234;ncia a longo prazo num paciente com um &#250;nico ventr&#237;culo"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1268
              "Ancho" => 1584
              "Tamanyo" => 244423
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Echocardiogram in apical 4-chamber view showing double-inlet dominant left ventricle &#40;A&#41;&#44; separated from the accessory right ventricle &#40;B&#41; by a hypoplastic intraventricular septum&#46; The atrioventricular connection is discordant&#58; mitral &#40;C&#41; and tricuspid &#40;D&#41; valves&#46; Pacemaker electrode &#40;E&#41;&#44; right atrium &#40;F&#41; and left atrium &#40;G&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Manuel Barreiro, Cec&#237;lia Corros, Laura Garc&#237;a, Alfredo Renilla, Mar&#237;a Martin, Ana Garc&#237;a"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Manuel"
              "apellidos" => "Barreiro"
            ]
            1 => array:2 [
              "nombre" => "Cec&#237;lia"
              "apellidos" => "Corros"
            ]
            2 => array:2 [
              "nombre" => "Laura"
              "apellidos" => "Garc&#237;a"
            ]
            3 => array:2 [
              "nombre" => "Alfredo"
              "apellidos" => "Renilla"
            ]
            4 => array:2 [
              "nombre" => "Mar&#237;a"
              "apellidos" => "Martin"
            ]
            5 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Garc&#237;a"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491300250X?idApp=UINPBA00004E"
    "url" => "/21742049/0000003200000009/v1_201312060118/S217420491300250X/v1_201312060118/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>"
    "titulo" => "Repaired acute type A aortic dissection&#58; Case closed&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "737"
        "paginaFinal" => "739"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Francisca Caetano, Andreia Fernandes, Joana Trigo, Susana Basso, Ana Botelho, Ant&#243;nio Leit&#227;o Marques"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "Francisca"
            "apellidos" => "Caetano"
            "email" => array:1 [
              0 => "franciscacaetano&#64;sapo&#46;pt"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Andreia"
            "apellidos" => "Fernandes"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Joana"
            "apellidos" => "Trigo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Susana"
            "apellidos" => "Basso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Ana"
            "apellidos" => "Botelho"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Ant&#243;nio"
            "apellidos" => "Leit&#227;o Marques"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servi&#231;o de Cardiologia&#44; Centro Hospitalar e Universit&#225;rio de Coimbra&#44; Hospital Geral&#44; Coimbra&#44; Portugal"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servi&#231;o de Radiologia&#44; Centro Hospitalar e Universit&#225;rio de Coimbra&#44; Hospital Geral&#44; Coimbra&#44; Portugal"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Dissec&#231;&#227;o a&#243;rtica tipo A aguda corrigida&#58; caso encerrado&#63;"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 919
            "Ancho" => 975
            "Tamanyo" => 72184
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Aortography showing false lumen forming a large saccular aneurysm &#40;red diamond&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Acute type A aortic dissection is a surgical emergency&#44; and the development of false aneurysms is one reason for reoperation&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">An 82-year-old man went to the emergency department with oppressive chest pain radiating to the back for three weeks and symptoms of heart failure&#44; in NYHA class III&#47;IV&#46; He had a history of acute type A aortic dissection and had had a Dacron tube graft implanted at the age of 64&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The transthoracic echocardiogram &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41; showed the Dacron graft in the ascending aorta and an apparent solution of continuity in the proximal portion of the anastomosis&#44; a large aneurysm &#40;53 mm &#215; 71 mm&#41; with thrombus compressing the pulmonary artery trunk &#40;peak gradient 27 mmHg&#41;&#44; and moderate to severe aortic regurgitation&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Thoracic computed tomography angiography &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figures 2 and 3</a>&#41; showed the Dacron tube from 2&#46;1 cm above the aortic valve leaflets to 1&#46;8 cm after the emergence of the brachiocephalic trunk surrounded by an image suggestive of an ascending aortic aneurysm &#40;10 cm &#215; 10 cm&#41; with two active contrast leaks at the ends of the graft &#40;type 1 endoleak&#41;&#44; compressing the right ventricle&#44; pulmonary artery trunk and right coronary artery&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Aortography &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>&#41; revealed an apparent proximal leak in the Dacron tube and a false lumen forming a large saccular aneurysm&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Following joint medical and surgical evaluation&#44; it was decided that the patient was unsuitable for cardiac surgery due to his multiple comorbidities &#40;chronic obstructive pulmonary disease&#44; obstructive sleep apnea syndrome and chronic renal failure&#41;&#44; which was also in agreement with his and his family&#39;s wishes&#46; He was discharged in NYHA class II&#8211;III&#47;IV&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The patient was readmitted four months later due to heart failure and died from a nosocomial infection&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:1 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-02-24"
    "fechaAceptado" => "2013-04-24"
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Caetano F&#44; Fernandes A&#44; Trigo J&#44; Basso S&#44; Botelho A&#44; Leit&#227;o Marques A&#46; Dissec&#231;&#227;o a&#243;rtica tipo A aguda corrigida&#58; caso encerrado&#63; Rev Port Cardiol&#46; 2013&#59;32&#58;737&#8211;739&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 522
            "Ancho" => 1301
            "Tamanyo" => 93272
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram showing the Dacron tube graft in the ascending aorta &#40;blue diamond&#41; and a large aneurysm &#40;53 mm &#215; 71 mm&#41; with thrombus &#40;red diamond&#41; and flow apparently originating from the proximal and distal ends of the tube&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 698
            "Ancho" => 975
            "Tamanyo" => 110140
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Thoracic computed tomography angiography showing contrast flow &#40;red diamond&#41; due to a proximal leak from the Dacron tube &#40;purple diamond&#41; and a large ascending aorta aneurysm with organized thrombus &#40;blue diamond&#41; compressing the pulmonary artery trunk &#40;green diamond&#41;&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 602
            "Ancho" => 1301
            "Tamanyo" => 133129
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Thoracic computed tomography angiography showing contrast flow &#40;red diamond&#41; due to a distal leak from the Dacron tube &#40;red diamond&#41; &#40;type 1 endoleak&#41;&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 919
            "Ancho" => 975
            "Tamanyo" => 72184
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Aortography showing false lumen forming a large saccular aneurysm &#40;red diamond&#41;&#46;</p>"
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003200000009/v1_201312060118/S2174204913002031/v1_201312060118/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9915"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Images in cardiology"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003200000009/v1_201312060118/S2174204913002031/v1_201312060118/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204913002031?idApp=UINPBA00004E"
]
Share
Journal Information
Vol. 32. Issue 9.
Pages 737-739 (September 2013)
Vol. 32. Issue 9.
Pages 737-739 (September 2013)
Image in Cardiology
Open Access
Repaired acute type A aortic dissection: Case closed?
Dissecção aórtica tipo A aguda corrigida: caso encerrado?
Visits
6528
Francisca Caetanoa,
Corresponding author
franciscacaetano@sapo.pt

Corresponding author.
, Andreia Fernandesa, Joana Trigoa, Susana Bassob, Ana Botelhoa, António Leitão Marquesa
a Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Hospital Geral, Coimbra, Portugal
b Serviço de Radiologia, Centro Hospitalar e Universitário de Coimbra, Hospital Geral, Coimbra, Portugal
This item has received

Under a Creative Commons license
Article information
Full Text
Download PDF
Statistics
Figures (4)
Show moreShow less
Full Text

Acute type A aortic dissection is a surgical emergency, and the development of false aneurysms is one reason for reoperation.

An 82-year-old man went to the emergency department with oppressive chest pain radiating to the back for three weeks and symptoms of heart failure, in NYHA class III/IV. He had a history of acute type A aortic dissection and had had a Dacron tube graft implanted at the age of 64.

The transthoracic echocardiogram (Figure 1) showed the Dacron graft in the ascending aorta and an apparent solution of continuity in the proximal portion of the anastomosis, a large aneurysm (53 mm × 71 mm) with thrombus compressing the pulmonary artery trunk (peak gradient 27 mmHg), and moderate to severe aortic regurgitation.

Figure 1.

Transthoracic echocardiogram showing the Dacron tube graft in the ascending aorta (blue diamond) and a large aneurysm (53 mm × 71 mm) with thrombus (red diamond) and flow apparently originating from the proximal and distal ends of the tube.

(0.09MB).

Thoracic computed tomography angiography (Figures 2 and 3) showed the Dacron tube from 2.1 cm above the aortic valve leaflets to 1.8 cm after the emergence of the brachiocephalic trunk surrounded by an image suggestive of an ascending aortic aneurysm (10 cm × 10 cm) with two active contrast leaks at the ends of the graft (type 1 endoleak), compressing the right ventricle, pulmonary artery trunk and right coronary artery.

Figure 2.

Thoracic computed tomography angiography showing contrast flow (red diamond) due to a proximal leak from the Dacron tube (purple diamond) and a large ascending aorta aneurysm with organized thrombus (blue diamond) compressing the pulmonary artery trunk (green diamond).

(0.11MB).
Figure 3.

Thoracic computed tomography angiography showing contrast flow (red diamond) due to a distal leak from the Dacron tube (red diamond) (type 1 endoleak).

(0.13MB).

Aortography (Figure 4) revealed an apparent proximal leak in the Dacron tube and a false lumen forming a large saccular aneurysm.

Figure 4.

Aortography showing false lumen forming a large saccular aneurysm (red diamond).

(0.07MB).

Following joint medical and surgical evaluation, it was decided that the patient was unsuitable for cardiac surgery due to his multiple comorbidities (chronic obstructive pulmonary disease, obstructive sleep apnea syndrome and chronic renal failure), which was also in agreement with his and his family's wishes. He was discharged in NYHA class II–III/IV.

The patient was readmitted four months later due to heart failure and died from a nosocomial infection.

Conflicts of interest

The authors have no conflicts of interest to declare.

Please cite this article as: Caetano F, Fernandes A, Trigo J, Basso S, Botelho A, Leitão Marques A. Dissecção aórtica tipo A aguda corrigida: caso encerrado? Rev Port Cardiol. 2013;32:737–739.

Copyright © 2013. Sociedade Portuguesa de Cardiologia
Download PDF
Idiomas
Revista Portuguesa de Cardiologia (English edition)
Article options
Tools
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

By checking that you are a health professional, you are stating that you are aware and accept that the Portuguese Journal of Cardiology (RPC) is the Data Controller that processes the personal information of users of its website, with its registered office at Campo Grande, n.º 28, 13.º, 1700-093 Lisbon, telephone 217 970 685 and 217 817 630, fax 217 931 095, and email revista@spc.pt. I declare for all purposes that the information provided herein is accurate and correct.