Prolapse of Aortic Intimal Flap Into the Left Ventricle A Rare Cause of Global Myocardial Ischemia in Acute Type A Aortic Dissection

Yoichi Sato; Hirono Satokawa; Shinya Takase; Yukitoki Misawa; Hitoshi Yokoyama

doi:10.1253/circj.70.214

Case Report

Prolapse of Aortic Intimal Flap Into the Left Ventricle

A Rare Cause of Global Myocardial Ischemia in Acute Type A Aortic Dissection

Yoichi Sato, Hirono Satokawa, Shinya Takase, Yukitoki Misawa, Hitoshi Yokoyama

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Keywords: Acute type A aortic dissection, Aortic regurgitation, Circumferential dissection, Myocardial ischemia, Proximal prolapse of intimal flap

JOURNAL FREE ACCESS

2006 Volume 70 Issue 2 Pages 214-215

DOI https://doi.org/10.1253/circj.70.214

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Abstract

A 62-year-old woman experienced an acute type A aortic dissection complicated with profound shock caused by acute myocardial ischemia. Intraoperative transesophageal echocardiography (TEE) identified a circumferentially dissected intimal flap at 5.5 cm above the aortic valve, prolapsing into the left ventricle through the aortic valve during diastole and obstructing both coronary ostia. Acute aortic dissection must be kept in mind when presented with myocardial ischemia and TEE is the most useful method for detecting a prolapsing cylindrical intimal flap. (Circ J 2006; 70: 214 - 215)

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