Painless aortic dissection late after aortic valve replacement, presenting as superior vena cava syndrome

Abstract

A 68-year-old man, who had underwent aortic valve replacement (AVR) with Björk-Shiley disc valve for aortic regurgitation 17 years ago, was transferred to our hospital complaining of facial redness and swelling, without chest or back pain. Preoperative examination revealed DeBakey type II aortic dissection, which caused superior vena cava syndrome (SVC syndrome). Emergent ascending aortic replacement was performed, postoperatively central venous pressure (CVP) decreased from 33 to 9 mmHg, and SVC syndrome was relieved. Painless aortic dissection after AVR, presenting as SVC syndrome, is a rare case, and close follow-up should be performed under consideration of painless aortic dissection late after AVR.

Association of Painless Acute Aortic Dissection With Increased Mortality

“…To our knowledge, no systematic study of painless AAD has been performed except for sporadic case reports. [9][10][11][12] The aim of the current study was to assess the clinical characteristics and outcomes of patients with painless AAD listed in the International Registry of Acute Aortic Dissection database. 8…”