Bennett Jeremy M, Sileshi Bantayehu
From the Division of Cardiovascular Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
A A Case Rep. 2017 Nov 1;9(9):254-257. doi: 10.1213/XAA.0000000000000582.
Early diagnosis of aortic dissection is important to reduce mortality, with surgical management representing standard treatment. Current methods of diagnosing type A aortic dissection include computed tomography angiography (CTA), magnetic resonance imaging, catheter-based arteriography, and transesophageal echocardiography. While each method has merits, there exists potential for false-positive findings. We present a case of a patient who was diagnosed with type A aortic dissection by CTA, but was found to not have an aortic dissection by transesophageal echocardiography under general anesthesia, preventing an unnecessary sternotomy. The echocardiographic findings suggested CTA artifact.
主动脉夹层的早期诊断对于降低死亡率很重要，手术治疗是标准治疗方法。目前诊断A型主动脉夹层的方法包括计算机断层血管造影（CTA）、磁共振成像、基于导管的血管造影和经食管超声心动图。虽然每种方法都有优点，但存在假阳性结果的可能性。我们报告一例患者，通过CTA诊断为A型主动脉夹层，但在全身麻醉下经食管超声心动图检查发现并无主动脉夹层，从而避免了不必要的胸骨切开术。超声心动图检查结果提示CTA存在伪影。
