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Review
. 2015 Oct-Dec;18(4):537-42.
doi: 10.4103/0971-9784.166463.

Intraoperative aortic dissection

Ajmer Singh  1 , Yatin Mehta
Affiliations
Review

Intraoperative aortic dissection

Ajmer Singh et al. Ann Card Anaesth. 2015 Oct-Dec.

Abstract

Intraoperative aortic dissection is a rare but fatal complication of open heart surgery. By recognizing the population at risk and by using a gentle operative technique in such patients, the surgeon can usually avoid iatrogenic injury to the aorta. Intraoperative transesophageal echocardiography and epiaortic scanning are invaluable for prompt diagnosis and determination of the extent of the injury. Prevention lies in the strict control of blood pressure during cannulation/decannulation, construction of proximal anastomosis, or in avoiding manipulation of the aorta in high-risk patients. Immediate repair using interposition graft or Dacron patch graft is warranted to reduce the high mortality associated with this complication.

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Figures

Figure 1
Figure 1
Transesophageal echocardiographic image demonstrating dissection flap (arrow) in the proximal ascending aorta (midesophageal aortic valve LAX view)
Figure 2
Figure 2
Transesophageal echocardiographic image showing dissection flap (arrow) in descending aortic SAX view
Figure 3
Figure 3
Three-dimensional echocardiographic image of descending aorta SAX view demonstrating true lumen (white arrow) and false lumen (black arrow)
Figure 4
Figure 4
A color flow Doppler image of descending aorta LAX view showing systolic flow within the true lumen (black arrow) and no flow in the false lumen (white arrow)
See this image and copyright information in PMC

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MeSH terms