This case demonstrates that long-term survival (16 years) after medical treatment of proximal aortic dissection is possible, though it can eventually progress to tamponade.
Late tamponade may complicate long-term survival after proximal aortic dissection; single case leaves open optimal surveillance needs.
A patient presented with tamponade and haemopericardium 16 years after experiencing sudden severe chest pain associated with enlargement of the proximal aorta. Investigations revealed a proximal aortic dissection (DeBakey type II) with extensive laminar and partially calcified thrombus within its false lumen and a large pericardial effusion, which together resulted in a cardiothoracic ratio of 100%. Long term survival after medical treatment of proximal aortic dissection, with such late progression to tamponade, has not been reported before.
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Fraser et al. (1987) studied this question.
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