Diagnostic criteria for penetrating atheromatous ulcer of the thoracic aorta Shigeki Kimura, MD, Makoto Noda, MD, Michio Usui, MD, Mitsuaki Isobe, MD

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Presentation transcript:

Diagnostic criteria for penetrating atheromatous ulcer of the thoracic aorta Shigeki Kimura, MD, Makoto Noda, MD, Michio Usui, MD, Mitsuaki Isobe, MD The Annals of Thoracic Surgery Volume 78, Issue 3, Pages 1070-1072 (September 2004) DOI: 10.1016/S0003-4975(03)01405-X

Fig 1 (A) Chest computed tomography (CT) scan showing dilatation of the ascending thoracic aorta without extravascular leakage of contrast medium. Note the presence of an area of heterogeneous low density between the posterior wall of the ascending thoracic aorta and the anterior wall of the trachea (asterisk). (B) Chest CT scan showing enlarged broncho-vascular markings on the lung (see inset for a magnified view of the area enclosed by a dotted line) and the slight pericardial effusion. The Annals of Thoracic Surgery 2004 78, 1070-1072DOI: (10.1016/S0003-4975(03)01405-X)

Fig 2 Macroscopic view (left) of the right posterolateral side of the heart obtained from an independent autopsy, shown for reference, and a schematic representation (right) of the heart shown on the left. Steel rods were inserted through the left atrium, the right atrium, and the transverse pericardial sinus, respectively. The estimated site of rupture in our patient (asterisk) was located in the posterior wall of the aortic root, just above the level of the upper pericardial reflection (closed circles). Dotted circles represent the superior and inferior left pulmonary veins. (Arch = aortic arch; LA = left atrium; RA = right atrium; SVC = superior vena cava; IVC = inferior vena cava; PA = pulmonary artery; PV = pulmonary vein.) The Annals of Thoracic Surgery 2004 78, 1070-1072DOI: (10.1016/S0003-4975(03)01405-X)