A Case of Chronic Aortic Dissection with Medial Calcification

Aims: Cystic medial necrosis is the most common pathological change of dissection. Medial calcification is mainly recognized in peripheral arteries and arterioles, but it can occur in the aorta. We, herein, report a case with chronic aortic dissection associated with medial calcification.

Presentation of Case: A 67-year-old woman presented with chest discomfort. Chest computed tomography showed a dilated ascending aorta associated with chronic aortic dissection, and medial and intimal calcification in the descending aorta. The aortic root and ascending aorta were replaced with a valved conduit. The postoperative course was uneventful. Pathological examination of the resected aorta showed cystic necrosis and calcification in the media.

Discussion and Conclusion: We cannot define that medial calcification was a secondary change after dissection in our case, but we think that the calcification of the media could lead to weakening of medial function, causing arterial or aortic distension and/or dissection.