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European Journal of Echocardiography 2008 9(1):139-140; doi:10.1016/j.euje.2007.04.003
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

Type A aortic dissection with partial ostial occlusion of left main coronary artery

Narayanan Namboodiri* and K. M. Krishnamoorthy

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695 011, India

Received 1 January 2007; accepted after revision 28 April 2007; online publish-ahead-of-print 22 June 2007.

* Corresponding author. Tel: +91 447838258; fax: +91 471 2446433. E-mail address: kknnamboodiri{at}sctimst.ac.in


  Abstract

A 48-year-old hypertensive male presented with acute retrosternal pain and aortic regurgitation. The electrocardiogram showed ST-segment depression with T-wave inversion in anterolateral leads. Transesophageal echocardiography in long axis view of aorta revealed a spiral intimal flap in ascending aorta extending to the arch, diagnostic of Type A aortic dissection. The short axis view of the aorta showed partial obstruction of the left main coronary artery (LMCA) by the intimal flap with turbulent flow at its ostium. An emergency repair of aortic dissection with reconstruction of aortic wall was done. Postoperative period and ECG were normal. At 12-months of follow up, patient was doing well.

Keywords: Left main coronary; Transesophageal echocardiography


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