Spontaneous contained rupture of the nonaneurysmal ascending aorta: Diagnostic importance of pericardial effusion

Abstract

A 58‐year‐old man with a history of hypertension, dyslipidemia, and an obtuse marginal branch coronary stent developed the sudden onset of chest pain. A contrast computed tomography demonstrated a penetrating ulcer of nondilating ascending aorta and a small pericardial effusion. Coronary angiography showed three‐vessel disease. At emergency surgery, there was blood in the pericardial sac and the whole of the ascending aorta had hematoma with no evidence of tamponade. We performed a hemiarch replacement under circulatory arrest and concomitant coronary artery bypass grafting. The left side of the proximal arch had ruptured just beyond the pericardial reflection.

Contained rupture of a sinus of Valsalva aneurysm: Is it just a matter of luck?

“…A spontaneous contained aortic rupture is a rare, but life-threatening condition [ 1 ]. The diagnosis of a contained aortic rupture is always demanding, since it shows no specific imaging findings and the signs and symptoms are primarily related to the site of the rupture, into the heart chambers, pericardial cavity or pulmonary artery [ 2 ].…”

“…The diagnosis of a contained aortic rupture is always demanding, since it shows no specific imaging findings and the signs and symptoms are primarily related to the site of the rupture, into the heart chambers, pericardial cavity or pulmonary artery [ 2 ]. A contained aortic rupture should always be suspected, in presence of an aortic aneurysm concomitantly detected with specific conditions, such as a pericardial effusion, a right atrial mass, or a continuous cardiac murmur [ 1 – 3 ]. We present herein a case of a completely asymptomatic contained aortic rupture, in which the operation was successfully performed and luck certainly played a role.…”