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Case reports

Penetrating ulcer of the ascending aorta without rupture

Department of Cardiac Surgery, Heart Institute, Hôpital de la Salpétrière, 50-52 Bd Vincent Auriol, 75013 Paris, France

Received 30 November 2008; received in revised form 9 December 2008; accepted 15 December 2008.

^_* Corresponding author. Tel.: +33 1 42 16 56 86; fax: +33 1 42 16 56 39. (Email: c.acar{at}psl.aphp.fr).

Penetrating ulcer of the ascending aorta is a very rare pathological entity with known potential for progression towards intramural hematoma or dissection. Intraoperative diagnosis of an asymptomatic ulcer of the ascending aorta was carried in a 60-year-old male with rheumatic valve disease. The tubular portion of the aorta was slightly dilated (45 mm) and the aortic valve was tricuspid. A supracoronary replacement of the ascending aorta was performed with a Dacron tube. Pathological analysis of the operative sample showed a considerable thinning of the aortic wall with a complete lack of elastic fibers at the level of the penetrating ulcer surrounded by a slightly dystrophic ascending aorta free from calcification and atheroma.

Key Words: Aortic ulcer • Ascending aorta replacement