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Diagnostic challenges with transesophageal echocardiography for intraoperative iatrogenic aortic dissection: Role of epiaortic ultrasound
Journal article   Open access   Peer reviewed

Diagnostic challenges with transesophageal echocardiography for intraoperative iatrogenic aortic dissection: Role of epiaortic ultrasound

Daniel Rhoades and Sudhakar Subramani
Annals of cardiac anaesthesia, Vol.24(1), pp.83-86
01/01/2021
DOI: 10.4103/aca.ACA_4_19
PMCID: PMC8081137
PMID: 33938839
url
https://doi.org/10.4103/aca.ACA_4_19View
Published (Version of record) Open Access

Abstract

Iatrogenic aortic dissection is a rare and serious complication of cardiac surgery with an incidence between 0.12% and 0.16%. Dissections involving an intimal flap can be detected using trans-esophageal echocardiography (TEE) with a sensitivity of 94%–100% and specificity of 77%–100%. Rarely, dissections can occur that are not detectable by TEE. There have been reports of iatrogenic dissection in the ascending aortic cannulation site; however, a dissection at the antegrade cardioplegia cannulation site is very rare. It also presents challenges associated with early diagnosis and appropriate intervention. We are describing a rare case of aortic dissection at the antegrade cardioplegia cannulation site in the proximal ascending aorta. The dissection was unable to be visualized with TEE initially, and required epi-aortic ultrasound to diagnose dissection in timely manner.
Antegrade cannula aortic dissection Case Report epi-aortic ultrasound

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