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Case Reports

Ascending Aortic Dissecting Aneurysm with Isolated Right Pulmonary Arterial Medial Intramural Hematoma

^a Department of Cardiovascular and Thoracic Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, College of Medicine, Kaohsiung, Taiwan
^b Department of Cardiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, College of Medicine, Kaohsiung, Taiwan
^c Department of Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, College of Medicine, Kaohsiung, Taiwan

Accepted for publication December 18, 2007.

^_* Address correspondence to Dr Ko, Department of Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, 123 Ta-Pei Rd, Niao-Sung Hsiang, Kaohsiung Hsien, 833, Taiwan (Email: sfa.ko{at}msa.hinet.net).

On rare occasions, acute aortic dissection may cause pulmonary artery obstruction when there is aortic rupture with hemorrhage into the common adventitia of the aorta and pulmonary artery. We report an extremely unusual case of an ascending aortic dissecting aneurysm associated with an isolated medial intramural hematoma in the right pulmonary artery in an 86-year-old woman with clinical manifestations mimicking pulmonary embolism. We believe that this rare pulmonary arterial complication of aortic dissection without involvement of the common adventitia has not been previously described.