67 yo female POD #2 from a 3 vessel Coronary Artery Bypass Graft with decreased urine output.
Contrast filled false lumen extending from the proximal thoracic aorta just distal to the take off of the coronary arteries to the aortic arch. There is thrombus within the false lumen. The coronary arteries and the other great vessels are not involved.
The patient was brought back to the OR for aortic replacement.
Aortic dissection is a known complcation of cardiac surgery. Typically patients present with chest or back pain, aortic insufficiency, blood pressure discrepancies between extremities, neurologic defects, ischemic extremities, or pulse deficits. Silent disection - such as this case - are rare.
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