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(A) Aortograph (lateral view) showing the markedly enlarged aortic arch. (B) Schematic representation of the enlarged aortic arch.
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The aortic arch enlargement was confirmed using aortography; the aortography showed an aneurysmal neo-aorta with an apple-shaped appearance (Fig. 1).
Analog recording of pressure measurement was performed using a high-fidelity micromanometer mounted on a 0.014-inch guidewire; the guidewire was advanced from the ascending aorta to the descending aorta.. Note: The ascending and descending aortic pressures were 82/42 mmHg and 82/52 mmHg, respectively, showing the paradoxically low diastolic pressure of the ascending aorta, without a systolic pressure gradient.
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The pressure measurements obtained using a high-fidelity micromanometer before performing an angiography showed intriguing aortic hemodynamics (Fig. 2).