Triple ultrasonography for iatrogenic acute aortic dissection caused by axillary arterial perfusion
| Autor: | Kazumasa Orihashi, Masaki Yamamoto, Miwa Tashiro, Hideaki Nishimori |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic arch medicine.medical_specialty Iatrogenic Disease 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Axillary artery law medicine.artery Internal medicine Catheterization Peripheral medicine Cardiopulmonary bypass Humans Cardiovascular Surgical Procedure Aged 80 and over Aortic dissection Aorta Aortic Aneurysm Thoracic business.industry medicine.disease Surgery Aortic Dissection 030228 respiratory system Acute Disease Axilla cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Complication Vascular Surgical Procedures Perfusion Echocardiography Transesophageal |
| Zdroj: | Interactive CardioVascular and Thoracic Surgery. 25:995-997 |
| ISSN: | 1569-9285 1569-9293 |
| DOI: | 10.1093/icvts/ivx179 |
| Popis: | Iatrogenic aortic dissection caused by axillary arterial cannulation or perfusion becomes a fatal complication of cardiopulmonary bypass when surgeons do not recognize it in the surgical field of view immediately during surgery. Therefore, we routinely monitor the aorta using 'triple ultrasonography' during cardiovascular surgery. An 85-year-old woman underwent partial arch replacement for chronic type A aortic dissection. During cardiopulmonary bypass, acute aortic dissection was observed in the aortic arch from the right axillary artery on real-time transoesophageal echocardiography. Epiaortic and neck surface ultrasonography detected malperfusion of the carotid artery. During femoral arterial perfusion, the patient was rescued with partial aortic replacement. Axillary artery cannulation is useful for cardiopulmonary bypass but confers a risk of iatrogenic aortic dissection that cannot be confirmed by surgeons surgically. The transoesophageal echocardiography can guard the aorta while systemic perfusion is initiated. Furthermore, epiaortic and neck surface echography can be incorporated to transoesophageal echocardiography. Triple ultrasonography allows for the detection of iatrogenic aortic dissection. |
| Databáze: | OpenAIRE |
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