case_images: PMC11776192_01
case_images: Preoperative CT angiography axial (A) and parasagittal (B) views depicting the intraluminal intimal flaps (marked with an asterisk) and the significant size of the post-dissection aneurysm of the ascending aorta
case_images: 13019_2025_3357_Fig1_HTML.jpg
case_images: PMC11776192_01_13019_2025_3357_Fig1_HTML.jpg
case_images: Fig1
case_images: In our center, a further acute CT angiography was performed, and the picture was suggestive of chronic Stanford type A AD with a significant (~ 80 x 75 mm) ascending aortic aneurysm (Fig. 1).
case_images: Intraoperative view of the enlarged aortic root. The intimal flaps were clearly visible upon the opening of the aorta
case_images: 13019_2025_3357_Fig2_HTML.jpg
case_images: PMC11776192_01_13019_2025_3357_Fig2_HTML.jpg
case_images: Fig2
case_images: Following preoperative preparation with levosimendan due to decreased left ventricular ejection fraction (35%), a Bentall operation with partial aortic arch replacement was performed the next day (Fig. 2).
case_images: CT angiogram showing a massive right-sided thoracic hematoma that was dislodging the mediastinum. The effusion was compressing the pulmonary arteries and the superior vena cava
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case_images: PMC11776192_01_13019_2025_3357_Fig3_HTML.jpg
case_images: Fig3
case_images: At 15 days postoperatively, due to generalized weakness, fatigue, and low blood count (hematocrit, 18%; red blood cell count, 2.01 T/L; hemoglobin, 6.1 g/dL), an acute CT angiography of the chest, abdomen, and pelvis was performed, revealing an active retrosternal bleeding at the level of the aortic arch and significant right-sided thoracic effusion (Fig. 3).