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Erbel, R., Oelert, H., Meyer, J., Puth, M., Mohr-Kahaly, S., Hausmann, D., et al. (1993) Effect of Medical and Surgical Therapy on Aortic Dissection Evaluated by Transesophageal Echocardiography. Implications for Prognosis and Therapy. Circulation, 87, 1604-1615.
https://doi.org/10.1161/01.CIR.87.5.1604

has been cited by the following article:

• TITLE: Proximal Aortic Dissection with Rupture into the Main Pulmonary Artery—A Case Report

  AUTHORS: Ramachandran Muthiah

  KEYWORDS: Dilated Aortic Root, Intimal Flap, Aortic Insufficiency, Aortic Rupture, Aortopulmonary Fistula

  JOURNAL NAME: Case Reports in Clinical Medicine, Vol.6 No.3, March 31, 2017

  ABSTRACT: Aim: To present a rare occurrence of aortopulmonary fistula due to rupture of proximal aortic dissection in a 48-year-old woman. Introduction: Aortic dissection is defined as disruption of the medial layer provoked by intramural bleeding, resulting in separation of aortic wall layers and subsequent formation of a true lumen and a false lumen with or without communication. Case Report: A 48-year-old female presented with vague anterior chest discomfort, high blood pressure, systolic-diastolic murmur in the left sternal border with ECG changes of myocardial ischemia. Echocardiography revealed a dilated aortic root with intimal flaps, a leak into the pulmonary artery and regional hypokinesis with contractile dysfunction suggesting a proximal aortic dissection with rupture into the main pulmonary artery. Discussion: The etiology of aortic dissection was mostly hypertension in 80% of cases and aortopathies such as connective tissue disorders, inflammatory and idiopathic. Aortic wall stress is a major trigger of intimal tear and two-dimensional transthoracic echocardiography is an excellent, initial diagnostic gold standard to detect the dissecting flaps, especially in proximal aortic dissection. Conclusion: Blood pressure control is the mainstay of treatment and urgent surgery is indicated in proximal aortic dissection since there is higher chance of rupture with an increase in mortality.