History of a type I aortic dissection status post repair. CHEST:LUNGS AND PLEURA: Basilar pulmonary opacities which are nonspecific but may reflect atelectasis.MEDIASTINUM AND HILA: Postsurgical changes from a type A aortic dissection repair. The dissection flap extends into the left subclavian, proximal left common carotid and right brachiocephalic arteries, appearing grossly similar to the prior study, although the great vessels are not well visualized due to technical factors.The aortic root measures 4.8 cm in AP dimension (series 1101, image 134), not significantly changed.The ascending aorta measures approximately 3.1 cm in AP dimension (series 1101, image 145), not significantly changed.The descending aorta measures 4.4 cm in AP dimension (series 1101, image 145), not significantly changed.The abdominal aorta measures 3.5 cm in AP dimension (series 1101, image 65), not significantly changed.Focal ulcerations within mural plaque within the false lumen appears similar to prior examinations.The celiac, superior mesenteric and right renal arteries appear to arise from the true lumen. The left renal and inferior mesenteric arteries appear to arise from the false lumen. The dissection flap extends to the iliac bifurcation beyond the inferior margin of the images.CHEST WALL: Sternotomy changes.ABDOMEN:LIVER, BILIARY TRACT: Probable subcentimeter hepatic cysts. No focal suspicious liver lesions. No biliary ductal dilatation. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts are unchanged and are without evidence of enhancement.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy. See above for discussion of the aorta.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
No significant change in type A aortic dissection status post repair. However, the components of the dissection within the great vessels are not well evaluated on this examination, and dedicated imaging of the neck (such as with a CTA) can be considered if clinically warranted.