Singh Ajmer, Mehta Yatin
Department of Cardiac Anaesthesia, Institute of Critical Care and Anesthesiology, Medanta The Medicity, Gurgaon, Haryana, India.
Ann Card Anaesth. 2015 Oct-Dec;18(4):537-42. doi: 10.4103/0971-9784.166463.
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.
术中主动脉夹层是心脏直视手术中一种罕见但致命的并发症。通过识别高危人群并在此类患者中采用轻柔的手术技术，外科医生通常可以避免对主动脉造成医源性损伤。术中经食管超声心动图和主动脉外膜扫描对于及时诊断和确定损伤范围非常重要。预防措施包括在插管/拔管、近端吻合构建过程中严格控制血压，或避免对高危患者的主动脉进行操作。应立即使用移植血管或涤纶补片进行修复，以降低与该并发症相关的高死亡率。
