PMC8636793_01
CT angiography on admission showed a simultaneous ascending aortic dissection and pulmonary artery dissection combined by aortopulmonary fistula. (A) Axial view, arrowhead showed the aortopulmonary fistula near the aorta root. (B) Axial view, arrowhead showed the aortopulmonary fistula near the PA. (C) Axial view, arrowhead showed the intimal flap of AA and arrow showed the intimal flap of PA. (D) Sagittal view, arrowhead showed the intimal flap of AA that was in the aorta root and arrow showed the artificial aortic valve. AA, ascending aorta; PA, pulmonary artery; DA, descending aorta.
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F1
The bedside echocardiography confirmed the normal function of the mechanical aortic valve with an ejection fraction of 50%. The patient was examined by CT angiography (CTA) after he was stabilized by medical treatment and it showed a simultaneous ascending aortic dissection extending to descending aorta and PAD combined by aortopulmonary fistula (Figure 1).