Goldman M E, Guarino T, Mindich B P
J Am Coll Cardiol. 1985 Nov;6(5):1155-9. doi: 10.1016/s0735-1097(85)80324-7.
Ascending (type I) aortic dissection carries a high morbidity and mortality. Proper identification of the proximal origin of the dissection and determination of concomitant aortic valve involvement significantly facilitate surgical repair, which may improve survival. In this case, intraoperative two-dimensional echocardiography with contrast injections was used to image the heart and great vessels before and after cardiopulmonary bypass. The proximal origin of the intimal flap of a type I dissection was identified, and primary aortic valve disease was excluded. Postprocedure intraoperative echocardiography demonstrated that the site of repair was imaged and that aortic regurgitation was absent. Intraoperative contrast two-dimensional echocardiography may be a valuable new tool to provide information otherwise unavailable by routine techniques.
升主动脉（I型）夹层具有较高的发病率和死亡率。准确识别夹层的近端起源并确定是否合并主动脉瓣受累，对手术修复有极大帮助，可能提高生存率。在此病例中，术中通过注射造影剂的二维超声心动图对体外循环前后的心脏和大血管进行成像。确定了I型夹层内膜瓣的近端起源，并排除了原发性主动脉瓣疾病。术后术中超声心动图显示修复部位成像良好，且无主动脉瓣反流。术中造影二维超声心动图可能是一种有价值的新工具，可提供常规技术无法获得的信息。
