Spontaneous rupture of the ascending aorta

J Card Surg. 2018 Feb;33(2):107-114. doi: 10.1111/jocs.13535. Epub 2018 Feb 6.

Abstract

Background: Nontraumatic, spontaneous rupture of the ascending aorta is rare and the etiology is largely unknown.

Methods: We reviewed seven patients from our institution, with no known aortic disease or hereditary connective tissue disorder that presented with spontaneous ascending aortic rupture from 2012 to 2017.

Results: Most patients presented with non-radiating chest pain along with hypertension (71.4%). The mean ascending aortic diameter at rupture was 4.60 ± 0.62 cm. The median door-to-operating room time was 2.58 h, resulting from effective implementation of an aortic emergency protocol. There were no operative mortalities.

Conclusions: In patients with ascending aortic rupture, aortic diameter may not always correlate with the risk of rupture. Rapid diagnosis combined with a multidisciplinary approach is vital for the successful management of these high-risk patients.

Keywords: ascending aorta; emergent; rupture.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aorta / diagnostic imaging*
  • Aorta / pathology
  • Aorta / surgery*
  • Aortic Diseases / complications
  • Aortic Diseases / diagnostic imaging*
  • Aortic Diseases / surgery*
  • Chest Pain / etiology
  • Emergencies
  • Female
  • Humans
  • Hypertension / etiology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Risk
  • Rupture, Spontaneous
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult