Coronary ostial involvement in acute aortic dissection: detection with 64-slice cardiac CT

Ryan, E. Ronan; Martos, Ramon; O'Neill, Ailbhe; Mc Creery, Charles; Dodd, Jonathan D.

doi:10.1016/j.clinimag.2009.03.010

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Volume 33, Issue 6 , Pages 471-473, November 2009

Coronary ostial involvement in acute aortic dissection: detection with 64-slice cardiac CT

E. Ronan Ryan
- Department of Radiology, Cardiac CT/MRI Program, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
- Corresponding author. St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Tel.: +353 86 2329384; fax: +353 1 2213391.
Ramon Martos
- Department of Cardiology, Cardiac CT/MRI Program, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
Ailbhe O'Neill
- Department of Radiology, Cardiac CT/MRI Program, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
Charles Mc Creery
- Department of Cardiology, Cardiac CT/MRI Program, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
Jonathan D. Dodd
- Department of Radiology, Cardiac CT/MRI Program, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland

Received 10 February 2009; accepted 13 March 2009. published online 20 May 2009.

Abstract

A 41-year-old man collapsed after lifting weights at a gym. Following admission to the emergency department, a 64-slice cardiac computed tomography (CT) revealed a Stanford Type A aortic dissection arising from a previous coarctation repair. Multiphasic reconstructions demonstrated an unstable, highly mobile aortic dissection flap that extended proximally to involve the right coronary artery ostium. Our case is an example of the application of electrocardiogram-gated cardiac CT in directly visualizing involvement of the coronary ostia in acute aortic dissection, which may influence surgical management.

Keywords: Heart, Tomography, X-ray Computed, Heart diseases/radiography