PMC8086691_01
A. Chest X-ray showed widening of the middle mediastinum and double pleural effusion; B-E. Computed tomography angiography revealed an aneurysm with limited dissection, compression of the superior vena cava and communication between the aortic aneurysm and main pulmonary artery (aortopulmonary fistula : arrows); F. Intraoperative view of the aortopulmonary fistula (arrow) and chronic dissection; AAA : ascending aortic aneurysm; PA : pulmonary artery; VCS : vena cava superior.
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Chest radiography revealed a widened mediastinum and pleural effusion (Fig. 1A). The patient underwent emergency surgery, which showed aortic degenerative disease, the aneurysm of the ascending aorta with chronic dissection and APF without infection or vegetation inside the aorta (Fig. 1F).