case_images: PMC11831696_01
case_images: Echocardiography images. A) The inner diameter of the ascending aorta was
  normal, about 34 mm. B) The maximum inner diameter of the aortic root is
  approximately 50 mm. C) Moderate regurgitation was displayed in the
  aortic valve during diastole. D) The pericardial cavity has an 8-mm-deep
  fluid-filled black region (arrow).
case_images: bjcvs-40-02-e20230401-g01.jpg
case_images: PMC11831696_01_bjcvs-40-02-e20230401-g01.jpg
case_images: f1
case_images: Transthoracic echocardiography was promptly performed, and the findings revealed that the sinus and root of the aorta were expanded, with a width of 50 mm at the largest point (Figure 1B). The patient had moderate aortic valve regurgitation and mild pericardial effusion (Figure 1C, D).
case_images: Computed tomography angiography images. A) Aortic root aneurysm (arrow).
  B, C) Hematoma around the ascending aorta and the aortic arch
  (arrow).
case_images: bjcvs-40-02-e20230401-g02.jpg
case_images: PMC11831696_01_bjcvs-40-02-e20230401-g02.jpg
case_images: f2
case_images: An ascending aortic aneurysm and an intramural hematoma in the ascending and arch portions of the aorta were confirmed (Figure 2A, B, C).
case_images: Intraoperative images. A, B) The volume of bloody pericardial effusion
  was about 300 ml (arrow). C) Aortic root aneurysm (arrow). D) The
  intimal break of aortic dissection was positioned above the left
  coronary sinus (arrow).
case_images: bjcvs-40-02-e20230401-g03.jpg
case_images: PMC11831696_01_bjcvs-40-02-e20230401-g03.jpg
case_images: f3
case_images: The volume of bloody pericardial effusion was approximately 300 ml (Figure 3A, B), and the distal ascending aorta was completely blocked. The intimal break was discovered to be positioned above the left coronary sinus after the aorta was incised, and the ascending aorta and aortic arch were involved in AoD (Figure 3D).
case_images: Computed tomography angiography images. A) The aortic dissection starts
  just proximal to the left subclavian artery and progresses along the
  descending aorta (arrows). B, C) The aortic dissection only involved the
  proximal end of the left common iliac artery and did not extend to the
  distal side (arrows).
case_images: bjcvs-40-02-e20230401-g04.jpg
case_images: PMC11831696_01_bjcvs-40-02-e20230401-g04.jpg
case_images: f4
case_images: The diameter of the aorta proximal to the left subclavian artery was 26 mm, and the lesion was situated near the start of the descending portion of the aortic arch (Figure 4).