Rapid aneurysmal degeneration of a Stanford type B aortic dissection in a patient with Loeys–Dietz syndrome Richard S. Lee, MD, Shafie Fazel, MD, Ulrike.

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Presentation transcript:

Rapid aneurysmal degeneration of a Stanford type B aortic dissection in a patient with Loeys–Dietz syndrome Richard S. Lee, MD, Shafie Fazel, MD, Ulrike Schwarze, MD, Dominik Fleischmann, MD, Gerald J. Berry, MD, David Liang, MD, D. Craig Miller, MD, R. Scott Mitchell, MD The Journal of Thoracic and Cardiovascular Surgery Volume 134, Issue 1, Pages 242-243.e1 (July 2007) DOI: 10.1016/j.jtcvs.2007.03.004 Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Transverse computed tomographic images at the level of the pulmonary artery demonstrate rapid expansion of the descending aortic aneurysm from 41 mm (A) to 45 mm (B) after 7 days. The Journal of Thoracic and Cardiovascular Surgery 2007 134, 242-243.e1DOI: (10.1016/j.jtcvs.2007.03.004) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Low-power magnification of aortic segment showing the dissection plane in the medial layer. The periadventitial tissue layer is thickened by granulation tissue and fibrous tissue admixed with chronic inflammatory cells (elastic–van Gieson stain ×15). B, Dissection along the outer portion of the medial layer. The dissection plane contains thrombus and early granulation tissue (hematoxylin–eosin stain ×200). Inset, Colloidal iron stain (×400) showing abundant mucopolysaccharide accumulations characteristic of cystic medial degeneration. The Journal of Thoracic and Cardiovascular Surgery 2007 134, 242-243.e1DOI: (10.1016/j.jtcvs.2007.03.004) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Preoperative and postoperative computed tomographic angiograms: Thin-slab maximum-intensity projection (viewed from the left side) of the thoracoabdominal aorta before (A) and after (B) repair of the descending thoracic aorta with a Dacron graft (arrows in A and B). Note the infrarenal aortic graft from prior surgery (arrowheads.) The Journal of Thoracic and Cardiovascular Surgery 2007 134, 242-243.e1DOI: (10.1016/j.jtcvs.2007.03.004) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions