PMC2821656_01
(a) Chest X-ray imaging showing as an aortic enlargement. (b) Spiral thoracic computed tomography imaging showing as a 16-cm aneurysm of ascending aorta. (c) The aortic aneurysm was occupying most of the space in the pericardial cavity. (d) and (e) The aneurysm of the ascending aorta was resected and implanted with a woven graft associated with the left and right coronary artery button implantation.
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fig1
An ascending aortic aneurysm was suspected with chest X-ray in routine follow-up of the patient who had not been controlled until that time (Figure 1(a)). Echocardiography and chest-enhanced computed tomography revealed a giant ascending aortic aneurysm about 16 cm in diameter with intact aortic arch (Figure 1(b)). A giant ascending aortic aneurysm was occupying most of the space in the pericardial cavity, with the heart lying posteriorly (Figure 1(c)). Distal anastomosis of the aortic graft was performed under aortic cross clamp (Figures 1(d) and 1(e)).
Pathological findings are demonstrating typical cystic medial degenerative changes. Histologically, it had the appearance in the media of "cystic spaces" filled with mucoid materials (arrow). (Hematoxylin & Eosin, original magnification x 100).
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fig2
Histological findings of the aortic aneurysm wall showed cystic medial necrosis (Figure 2).