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Ann Thorac Surg 2006;82:2274-2276
© 2006 The Society of Thoracic Surgeons

Case Reports

Intimo-Intimal Intussusception of the Aorta

Pallav J. Shah, MCha, Sanjay S. Singh, MCHa, Salim S. Chaloob, MBChBa, Clayton Lang, MBBSa, James Taylor, FRACPb, James R. Edwards, FRACSa,*

a Department of Cardiac Surgery, Royal Adelaide Hospital, Adelaide, Australia
b Department of Radiology, Royal Adelaide Hospital, Adelaide, Australia

Accepted for publication May 5, 2006.

* Address correspondence to Mr Edwards, Department of Cardiac Surgery, Level 4, East Wing, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia. (Email: jedward1{at}mail.rah.sa.gov.au).

A 50-year-old man presented with acute onset of chest pain. Subsequent transesophageal echocardiography and computed tomography scan showed absence of a flap in the ascending aorta and a clear dissection flap involving the arch and descending aorta. Magnetic resonance imaging showed a tear and a small flap in the right coronary sinus. During surgery, we found a total circumferential intimal tear at the sinotubular junction with intimo-intimal intussusception of the internal channel into the arch. Dissection without intimal flap and aortic intussusception is a rare form of type A dissection, which is difficult to diagnose on routine investigations and can delay treatment.




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