[Ruptured Ascending Aortic Aneurysm:Report of a Case].

A 62-year-old man was transferred to our hospital for consciousness loss, and contrast-enhanced computed tomography( CT) scans showed a 50-mm ascending thoracic aortic aneurysm( ATAA) with a little pericardial effusion. The patient became stable and was admitted for observation without any invasive treatments in the department of cardiology. On the 5th hospital day, however, repeated CT scans revealed increased pericardial effusion. Bloody fluid was drained in pericardiocentesis, and the patient was referred to our department. Ruptured ATAA was diagnosed, and emergency surgery was conducted. Although there was no bleeding after removing intrapericardial hematoma, bleeding from a pinhole of the aortic right side adjacent to the right atrium was recognized when the dilated proximal ascending aorta was raised to the left. Aortic root and ascending aortic replacement were performed because the aneurysm reached the ostium of the right coronary artery. Postoperative course was uneventful, and the patient was discharged on postoperative day 29.