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- Title
A type A aortic dissection missed by non-cardiac gated contrast-enhanced computed tomography due to an aortic root dissection flap masquerading as an aortic valve apparatus: a case report.
- Authors
Nagra, Karan; Coulden, Richard; Sean McMurtry, Michael
- Abstract
Introduction Though computed tomographic angiography has very high sensitivity and specificity to diagnose acute aortic dissection, false-negative studies can occur and secondary tests may be required to make the diagnosis. Case presentation We report the case of a 57-year-old Caucasian man with a typical presentation for acute type A aortic dissection in whom the initial non-cardiac gated computed tomographic angiogram was negative, leading to a delay in surgical management. Transesophageal echocardiography and post hoc 3D reconstruction of the original computed tomographic scan revealed a dissection flap confined to the aortic root, immediately superior to the sinuses of Valsalva and masquerading as part of the aortic valve apparatus. Conclusion This case demonstrates that false-negative computed tomographic angiograms taken to rule out type A aortic dissection can occur and that secondary imaging tests, such as echocardiography, should be performed in cases in which the pre-test probability of aortic dissection is high. Cardiac gating of computed tomographic angiograms to exclude aortic dissection may enhance diagnostic accuracy.
- Subjects
AORTIC dissection; COMPUTED tomography; AORTIC valve abnormalities; ANGIOGRAPHY; ELECTROCARDIOGRAPHY; TRANSESOPHAGEAL echocardiography; ASCENDING aorta dissection
- Publication
Journal of Medical Case Reports, 2013, Vol 7, Issue 1, p1
- ISSN
1752-1947
- Publication type
Case Study
- DOI
10.1186/1752-1947-7-285