Abstract:
We report an unusual clinical presentation of an acute type A aortic dissection as a left
hemothorax in a patient with a congenital pericardial defect. Although the pericardial
defect was diagnosed preoperatively, we could not exclude the possibility of a ruptured
descending aorta until we discovered the site of the rupture during operation.
The presence of a pericardial defect would at first appear to be a fatal disadvantage
in such a situation as this, due to massive bleeding into the pleural space; but we believe
that in our patient spontaneous drainage of blood into the pleural cavity prevented
severe cardiac tamponade. The only reason for his deteriorating hemodynamic status was
hypovolemia, which was corrected with volume replacement. (Tex Heart Inst J 2005;32:
241-3)
