Panel A. Aortic dissection with a systolic flow in the true lumen (TL) of ascending aorta on TEE. A continual flow can be seen in the false lumen (FL) in which an intraluminal thrombus (T) is evident.
Panel B. A hypermobile double lobar thrombus connected to the penetration canal (P) heading to left atrial roof.
Panel C. Continuous turbulent jet heading from the aorto-left atrium fistula canal (P) to left atrial roof.
Panel D. Double intimal tear in descending aorta.
Panel E. A reconstructed three-dimensional CT image using volumetric rendering method. An evident aneurysmatic dissection of ascending aorta with a rupture of aortic adventitia and penetration into left atrium (arrow).
Panel F. An extensive thoracic aorta aneurysm dissection penetrating into left atrium. A tricuspid aortic valve (Ao), left ventricle (LV), and an intimal line (I) separating true aortic lumen (TL) from false lumen (FL) can also be noticed. Hypodense masses with an irregular margin lining the edges of a proximal part of a false lumen are thrombi (T) penetrating into the left atrium (LA).
Panel G. Short axis CT image of ascending and descending aorta.
Panel H. Distal part of dissection in area of right common iliac artery (white arrow).
Panel I. A view of a false lumen with a noticeable penetration opening into left atrium. The arrows are pointing towards its CT angiography and TEE correlates. The true aortic lumen is compressed by a suction tube.