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


      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.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Daily PO
        • Trueblood HW
        • Stinson EB
        • Wuerflein RD
        • Shumway NE
        Management of acute aortic dissections.
        Ann Thorac Surg. 1970; 10: 237-247
        • Hoffmann U
        • Nagurney JT
        • Moselewski F
        • Pena A
        • Ferencik M
        • Chae CU
        • et al.
        Coronary multidetector computed tomography in the assessment of patients with acute chest pain.
        Circulation. 2006; 114: 2251-2260
        • Erbel R
        • Alfonso F
        • Boileau C
        • Dirsch O
        • Eber B
        • Haverich A
        • et al.
        Diagnosis and management of aortic dissection.
        Eur Heart J. 2001; 22: 1642-1681
        • Johnson TR
        • Nikolaou K
        • Becker A
        • Leber AW
        • Rist C
        • Wintersperger BJ
        • et al.
        Dual-source CT for chest pain assessment.
        Eur Radiol. 2007;
        • White CS
        • Kuo D
        • Kelemen M
        • Jain V
        • Musk A
        • Zaidi E
        • et al.
        Chest pain evaluation in the emergency department: can MDCT provide a comprehensive evaluation?.
        Ajr. 2005; 185: 533-540
        • Johnson TR
        • Nikolaou K
        • Wintersperger BJ
        • Knez A
        • Boekstegers P
        • Reiser MF
        • et al.
        ECG-gated 64-MDCT angiography in the differential diagnosis of acute chest pain.
        Ajr. 2007; 188: 76-82
        • Goldstein JA
        • Gallagher MJ
        • O'Neill WW
        • Ross MA
        • O'Neil BJ
        • Raff GL
        A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain.
        J Am Coll Cardiol. 2007; 49: 863-871
        • Rubinshtein R
        • Halon DA
        • Gaspar T
        • Jaffe R
        • Karkabi B
        • Flugelman MY
        • et al.
        Usefulness of 64-slice cardiac computed tomographic angiography for diagnosing acute coronary syndromes and predicting clinical outcome in emergency department patients with chest pain of uncertain origin.
        Circulation. 2007; 115: 1762-1768
        • Stillman AE
        • Oudkerk M
        • Ackerman M
        • Becker CR
        • Buszman PE
        • de Feyter PJ
        • et al.
        Use of multidetector computed tomography for the assessment of acute chest pain: a consensus statement of the North American Society of Cardiac Imaging and the European Society of Cardiac Radiology.
        Eur Radiol. 2007; 17: 2196-2207