Circumferential Dissection with Intimal Intussusception: An Unusual Case of Acute Aortic Type A Dissection

Abstract

An unusual case of a type-A aortic dissection with complete circumferential dissection just above the aortic valve with intimointimal intussuseption just distal to the left subclavian artery partially obstructing the descending aorta is described. CT-scan and transesophageal echocardiography together with clinical suspicion led to the correct diagnosis.

Intimointimal intussusception is an unusual type of aortic dissection in which a proximal circumferential tear causes dissection with intussusception of the torn intima downstream, which could cause confusion about the appropriate diagnosis [1]. It is a very infrequent complication of aortic dissection with only a few cases reported in the literature [2–6]. CT scan and transesophageal echocardiography are the most accurate diagnostic tools [7–9]. We describe a patient with intimointimal intussusception, diagnosed by CT scan and transesophageal echocardiography.