Type A dissection with normal coronaries arising from the true lumen

This is one addition to the list of indications for a cardiac CT. This patient was known to have a type A dissection, but the surgeon wanted to know the status of all the vessels, starting from the coronaries, right upto the iliacs. The study was done in two stages, with a cardiac CT done first, followed an hour later with an aortogram from the mid-neck to the mid-thighs.

The CT clearly shows the true lumen (red arrows in Figs. 1, 2) and the RCA (green arrow in Fig. 3) and the left coronary tree arising from the true lumen. The coronaries were otherwise normal.