Subtle aortic dissection in a patient with severe aortic regurgitation and undiagnosed bicuspid aortic valve: A case report with a literature review. Issue 9 (1st June 2021)

• Record Type: Journal Article
• Authors: Sef, Davorin; Brown, Stewart; Jarral, Omar A.; Hussain, Azhar; Haslam, Elizabeth; Rajakaruna, Cha; McAloon, Christopher J.
• Is Part Of: Journal of cardiac surgery. Volume 36:Issue 9(2021)
• Page Start: 3417
• Page End: 3420
• Publication Date: 2021-06-01
• Subjects: aorta -- aortic regurgitation -- aortic root replacement -- misdiagnosis -- Subtle aortic dissection; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.15714
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Background and aim of the study: A subtle aortic dissection can be challenging to detect despite the availability of multiple diagnostic modalities. Whilst rare, the inability to detect this variant of aortic dissection can lead to a dismal prognosis. We present an extremely rare case of a subtle aortic dissection with supra‐annular aortic root intimal tear and acute severe aortic regurgitation in a patient with a bicuspid aortic valve. Methods: Case report and literature review conserning subtle aortic dissection is provided. Results: Initial concerns were either aortic dissection or infective endocarditis. Despite advanced multimodality preoperative imaging, diagnosis was made intraoperatively and a Bentall procedure with a mechanical aortic valve was performed. Conclusions: Our case along with the review of current literature emphasizes that current imaging techniques may be inadequate for diagnosis of this rare variant of aortic dissection.