Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Ann Card Anaesth. 2021 Jan-Mar;24(1):83-86. doi: 10.4103/aca.ACA_4_19.
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.
医源性主动脉夹层是心脏手术的一种罕见且严重的并发症，其发病率在 0.12%至 0.16%之间。涉及内膜瓣的夹层可以使用经食管超声心动图（TEE）检测，其敏感性为 94%至 100%，特异性为 77%至 100%。很少有 TEE 无法检测到的夹层。有报道称在升主动脉插管部位发生医源性夹层；然而，顺行冠状静脉窦插管部位的夹层非常罕见。它还存在与早期诊断和适当干预相关的挑战。我们描述了一例罕见的近端升主动脉顺行冠状静脉窦插管部位主动脉夹层病例。夹层最初无法通过 TEE 显示，需要主动脉外超声及时诊断夹层。
