A bidirectional closing aortic dissection from an atherosclerotic distal aortic arch aneurysm: Report of a case

We experienced one rare case of a 76-year-old male with a Stanford type A b idirectional closing aortic dissection from a coexisting atherosclerotic di stal arch aneurysm. He showed a cardiac tamponade, and effective pericardia l drainage allowed us to conservatively manage the patient. Both an increas e in the size of the aneurysm and a recrudescent dissection in the descendi ng aorta were identified 2 months after the onset. A scheduled surgical rep air was successful. The coexistence of an acute aortic dissection and an at herosclerotic aneurysm increases the risk of an aortic rupture, particularl y at the confluence of the two lesions, Meanwhile, the management of a clos ing aortic dissection remains controversial because its characteristics sti ll are not well known. We studied not only the pathogenesis but also the ma nagement of these two forms of aortic disease and their complex relationshi ps.