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Ann Thorac Surg 1991;52:537-540
© 1991 The Society of Thoracic Surgeons

Articles

Combined thoracic aortic dissection and abdominal aortic fusiform aneurysm

Charles Stewart Roberts, MD*, William Clifford Roberts, MD

Surgery and Pathology Branches, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA

Accepted for publication May 15, 1991.

* Address reprint requests to Dr Roberts, Pathology Branch, Building 10, Room 2N258, NHLBI-NIH, Bethesda, MD 20892.

Certain clinical and autopsy findings are described in 13 patients who had both aortic dissection (AD) and fusiform abdominal aortic aneurysm (AAA). All 13 patients had severe and extensive aortic atherosclerosis. The AAA was diagnosed clinically in 9 patients, and 5 had the AAA resected. The AD was diagnosed clinically in 5 patients, and 2 underwent attempted operative repair. Two patients who had the AAA resected because of suspected rupture were found later to have ruptured a more proximal AD. Thus, AD occurs occasionally in patients who have AAA. In older persons with suspected rupture of an AAA, a more proximal rupture of an AD should be ruled out. When both AAA and AD are present in the same patient, the AD is more likely the cause of cardiovascular collapse than is rupture of the AAA.




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