The Rarity of Penetrating Ulcer with Intramural Hematoma of the Ascending Aorta

We report a case of a 58-year-old man with multiple symptomatic penetrating atherosclerotic ulcers and concomitant intramural hematoma of the ascending aorta. The patient was successfully treated using a 24-mm Gelweave graft in the ascending aorta. He was discharged four days post operation and remains asymptomatic 14 months postoperatively. This case uniquely illustrates the rare entity of penetrating atherosclerotic ulcer with intramural hematoma, which presents in only 0.28% of all acute aortic syndrome cases.