Prasad Gaurav Kalla Krishna, Kumar Bhupesh, Thingnam Shyam K S
Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Ann Card Anaesth. 2018 Oct-Dec;21(4):427-429. doi: 10.4103/aca.ACA_218_17.
Traumatic aortic dissection following sudden deceleration injury requires urgent treatment as it may result in formation of aneurysm that may expand or rupture leading to catastrophe. Confirmation of diagnosis of aortic dissection often requires contrast-enhanced computed tomography (CECT) or magnetic resonance imaging, which is time-consuming. Often, there is a significant time lag between the CECT chest and surgical intervention. Progression of aortic dissections may be missed on CECT chest, which would be done in the initial hours after injury. Transesophageal echocardiography (TEE) is equally efficient for the diagnosis of aortic dissection. It may also provide additional information that can be very useful for the management. We report the case of a descending thoracic aortic dissection where TEE plays a crucial role during the surgical management of the patient.
突然减速损伤后发生的创伤性主动脉夹层需要紧急治疗,因为它可能导致动脉瘤形成,动脉瘤可能扩大或破裂,从而引发灾难。主动脉夹层的诊断通常需要增强计算机断层扫描(CECT)或磁共振成像,这很耗时。通常,CECT胸部检查与手术干预之间存在显著的时间间隔。在受伤后的最初几个小时进行的CECT胸部检查可能会漏诊主动脉夹层的进展情况。经食管超声心动图(TEE)在诊断主动脉夹层方面同样有效。它还可能提供对治疗非常有用的额外信息。我们报告一例降主动脉夹层病例,其中TEE在患者的手术治疗中发挥了关键作用。