Chigozirim N. Ekeke, BS, Curt Daniels, MD, Subha V

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Annuloaortic Ectasia in a Patient With Congenital Absence of the Left Pericardium Chigozirim N. Ekeke, BS, Curt Daniels, MD, Subha V. Raman, MD, Charles Hitchcock, MD, PhD, Steven E. Katz, MD, Juan A. Crestanello, MD The Annals of Thoracic Surgery Volume 96, Issue 6, Pages 2243-2245 (December 2013) DOI: 10.1016/j.athoracsur.2013.04.106 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A–E) Computed tomography angiography demonstrates extreme displacement of the heart into the left hemithorax with the apex pointing posteriorly. The findings are consistent with congenital absence of pericardium. Note the relatively normal location of the aortic root, ascending aorta, and arch. (F) The aortic root was dilated. The aortic annulus was 3.3 cm. The sinuses of Valsalva measured 4.3 cm × 4.2 cm × 4.0 cm (z score = 2.07). The sinotubular junction was 3.8 cm. The ascending aorta was 3.9 cm × 3.6 cm. The proximal arch was 3.4 cm, and the descending aorta was 2.5 cm. (G) Histologic examination of the aortic wall was consistent with medial necrosis. Excess glycosaminoglycan deposition within the media of the aorta is seen as light blue staining on hematoxylin and eosin stained sections (magnification, ×100). (AoR = aortic root; Dao = descending aorta; LV = left ventricle; RV = right ventricle.) The Annals of Thoracic Surgery 2013 96, 2243-2245DOI: (10.1016/j.athoracsur.2013.04.106) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions