A 50-year-old man was operated on for acute type I (DeBakey classifica
tion) aortic dissection. The supracoronary ascending aorta was replace
d with an interposition graft. Postoperative computed tomography and a
ngiography clearly revealed a double-barrelled aortic arch, left commo
n carotid artery and descending thoracoabdominal aorta with contrast f
illing of both true and false lumen starting from the distal anastomos
is. The same finding was noted at 1 year follow-up with severe compres
sion of the true lumen by the false lumen. At this time, anticoagulati
on therapy was stopped. One year later: computed tomography showed spo
ntaneous resolution of the dissection in the aortic arch, left common
carotid artery and descending aorta over its full length. This was con
firmed by angiography. This case reports illustrates that spontaneous
resolution of a dissected descending aorta can occur late after surger
y from type I dissection, but it remains very rare. (C) 1997 Elsevier
Science B.V.