Circumferential Dissection of the Aorta

Figure 1. A 68-year-old woman was admitted to the emergency room with sudden left hemiparesis. A computed tomographic scan of the brain showed an image consistent with infarction of the right frontal lobe. A transthoracic echocardiogram suggested that dissection of the ascending aorta had occurred. Transesophageal echocardiography was performed immediately thereafter and confirmed the diagnosis. A wide dissection of the proximal aorta compromised more than 270 degrees of the vessel's circumference and extended to the descending thoracic aorta. The redundant, dissected wall was plicated, producing a wave-shaped image in the transverse plane of the echocardiogram (Panel A) and duplicated aortic . . .