{'fraction_non_alphanumeric': 0.030797101449275364, 'fraction_numerical': 0.01177536231884058, 'mean_word_length': 5.242937853107344, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Penetrating atherosclerotic ulcer of the ascending aorta

A 70-year-old female with a history of hypertension, a myocardial infarction, and a stable <5-cm ascending aortic aneurysmwas admitted with acute chest pain and elevated cardiac enzymes. Coronary angiography revealed an 80% stenosis of the left anterior descending (LAD) artery, and a 90% stenosis of the posterior descending artery (PDA). A computed tomography angiogram demonstrated a 5-cm ascending aortic aneurysm originating above the sinotubular junction (STJ) and extending to 3 cm below the aortic arch. In addition, there was a huge penetrating atherosclerotic ulcer (PAU) just above the noncoronary sinus of Valsalva (Figure 1). At the time of surgery, cardiopulmonary bypass was initiated with an arterial arch cannula and a two-stage right atrial venous cannula. Following cardioplegic arrest with antegrade, cold, crystalloid cardioplegia, a transverse aortotomy was performed revealing the PAU without any evidence of an intimal flap (Figures 2 and 3). The ascending aorta was resected from just above the STJ to 3 cm below the arch