Aims and objectives
The aortic root and central pulmonary artery (main pulmonary artery,
left/right pulmonary artery trunk) have an anatomical common adventitial[1-3],
connective tissue sheath structure[2,
especially in the posterior wall of the aortic root.
In type A aortic dissection or intramural hematoma,
the aortic wall ruptures to the adventitia.
Increased intramural pressure causes extravasation,
or breaks into the common adventitia and continues to the main pulmonary artery and the left and right pulmonary artery,
resulting in pulmonary artery hematoma.
When the hematoma is large,
Methods and materials
Study Population and Definitions
A total of 2133 consecutive cases of type A acute aortic dissection (AD) or intramural hematoma (IMH) were diagnosed by CT in Beijing Fuwai Hospital from January 2010 to December 2017.
264 cases of them were pulmonary artery involvement by CT retrospective diagnosis.
Acute aortic Syndrome(AAS) is defined as 14 days or fewer from symptom onset.
Classic AD was defined as the dissection with visible intimal tear and flow communication between true and false lumen.
IMH was defined as a...
Among 2133 patients with type A aortic dissection or intramural hematoma,
264 patients were retrospectively diagnosed with pulmonary artery involvement,
and the detection rate was 12.38% (264 of 2133).
The age of 264 patients ranged from 28 to 90 years (mean age 57.6±11.9),
including 171 males and 93 females.
CT examination results
There were 191 cases of type A aortic dissection and 73 cases of type A intramural hematoma in 264 patients.
As for the pulmonary artery involvement,
7 cases had dissection...
Stanford type A acute AD is a emergent and severe event in clinic.
The literature reported a pre-hospital mortality rate of 49% and a mortality rate of 47-57% within 30 days after admission[9,
Although the optimal treatment remains controversial,
Song et al suggest timely surgery by cutoff values of 16 mm for IMH thickness and 55 mm for external diameter of ascending aorta.
Multiple studies have shown that the aortic diameter is an independent predictor of dissection and intramural hematoma.
In this study,
Stenosis of the right pulmonary artery: a complication of acute dissecting aneurysm of the ascending aorta.
Am Heart J 1972; 83:89-92
gross and microscopic images of hemorrhage along the pulmonary artery sheath due to type A aortic dissection.
Forensic Sci Med Pathol 2015; 11:455-459
Aortic dissection: anatomy,
Am Heart J 1981; 101:195-214
Occlusion of the right pulmonary artery...