An 86-year-old woman presented with sudden back pain. Computed tomography (CT) revealed thrombosed type A acute aortic dissection (AD) with a large ascending aorta. Due to the patient's advanced age, medical therapy was performed. While an ulcer-like projection was recognized at the ascending aorta on follow-up CT, the patient was eventually discharged without surgery. Four-months follow-up CT showed complete resorption of the thrombus in the false lumen. While the patient was asymptomatic after discharge, 1 year later, CT revealed overt AD involving the ascending aorta. In order to prevent aortic events, we performed graft replacement of the ascending aorta.
Keywords: painless dissection; redissection; thrombosed type A acute aortic dissection.