CT and TTE Imaging Reveal a Complex Aortic Dissection in a Patient With Marfan Syndrome

A 43-year-old woman with Marfan syndrome who underwent ascending aortic dissection repair five years ago presents with progressive dyspnea and chest pain for two hours. Her vital signs were normal, and there was no cardiovascular, neurological, or renal dysfunction. Computed tomographic examination of the body confirmed a very complex aortic dissection starting from the aortic root (Figure A), below to bilateral iliac arteries (Figure E) and upwards to both carotid arteries (Figure F). A small obliterated true lumen feeding the renal and iliac arteries is displayed in Figure C and E. Transthoracic echocardiogram revealed enlarged aortic root with dissection flap in ascending aorta, normal aortic valve, and almost obliterated left atrium by dilated descending aorta and large thrombus burden (Figures G, H). The patient underwent urgent surgery at specialized center. Complex repair of the aorta and peripheral arteries was performed, and she is recuperating well without any neurological or end organ deficit.

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