AORTIC DISSECTION IN 26 YEARS OLD MALE WITH BICUSPID AORTIC VALVE ASSOCIATED ANEURYSM: CASE REPORT

Lavdim IBRAIMI, Vegim ZHAKU

Abstract

Aortic dissection is a very dangerous, fatal and emergency condition which requires immediate surgical intervention. It mainly affects patients after 50 years old, and is very unusual in younger patients. It has been traditionally associated with other pathological conditions such as: trauma, Marfan syndrome, Ehlers-Danlos syndrome, bicuspid aortic valve and pregnancy. The patient is a 26-year-old male who was presented in the emergency department with acute chest pain, epigastric discomfort and nausea. ECG showed sinus tachycardia (110 bpm) other findings were normal. Cardiac ultrasound showed an ascending aortic aneurysm at 60 mm, a possible presence of an intimal tear in the ascending aorta as well and a suspect bicuspid aortic valve with moderate aortic regurgitation. The patient was admitted to another hospital where the diagnosis of acute aortic dissection type A (De Bakey I) was confirmed with CT angiography of the chest. He was emergently operated with simultaneous replacement of the aortic valve and ascending aorta with a composite and had a satisfactory clinical course. Acute aortic dissection in young adults is very rare condition. The disease may be easily misdiagnosed for other cardiac, muscular, neurological, esophageal or renal diseases. The presence of bicuspid aortic valve is associated with dilatation of proximal aorta increasing their risk of aortic dissection 8 -fold. Prompt surgical intervention with replacement of the affected part of the aorta offers a survival benefit for the patient.

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