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- Received March 21, 2011
- Accepted March 30, 2011
- Published online September 20, 2011.
In February 2000, a 56-year-old man sought treatment at our emergency department with severe chest pain. The computed tomography (CT) scan showed acute type A aortic dissection. An emergent surgical repair was performed. After discharge, he kept regular close follow-up and periodic imaging surveillance at our out-patient clinic (A and B). Four years later, unfortunately, he sought treatment for an episode of disseminated intravascular coagulation. The chest radiograph (C) and CT scan (I and J) showed a very large chronic, dissecting aneurysm with maximal diameter up to 7.7 cm at the distal arch and uppermost descending thoracic aorta. Surgical intervention was advised, but the patient declined. Surprisingly, repeat chest radiographs (D to H) and CT scans (K to N) showed that the size of the aneurysm became smaller year by year. Elefteriades and Frankas (1) reported that there is a sudden increase risk for aortic rupture when the descending aorta diameter reaches 7.0 cm. Interestingly, the significant regression to only 3.3 cm after 10 years of follow-up is a paradoxical phenomenon.
- Received March 21, 2011.
- Accepted March 30, 2011.
- American College of Cardiology Foundation