Ohashi Y, Onishi Y, Akamatsu T, Maruyama K, Kuro M
Department of Anesthesiology, National Cardiovascular Center, Suita.
Masui. 1996 Oct;45(10):1281-4.
Acute aortic dissection is a rare complication of cardiac surgery. But once it happens, its outcome is often miserable. We experienced this complication after discontinuing cardiopulmonary bypass (CPB). A 56-year old man with mitral regurgitation was referred for mitral valve replacement under CPB. After weaning from extracorporeal circulation (ECC), the right radial artery pressure decreased suddenly and its waveform became flat. After 5 minutes, dissection of the ascending aorta was diagnosed by transesophageal echocardiography (TEE). We started to prevent ischemic brain damage immediately, but a severe brain damage occurred. Its early diagnosis is necessary and the prevention of critical brain damage due to low perfusion of the blood is important for anesthetic management.
急性主动脉夹层是心脏手术中一种罕见的并发症。但一旦发生,其后果往往很严重。我们在停止体外循环(CPB)后遇到了这种并发症。一名56岁二尖瓣反流男性患者接受CPB下二尖瓣置换术。脱离体外循环(ECC)后,右桡动脉压力突然下降,波形变平。5分钟后,经食管超声心动图(TEE)诊断为升主动脉夹层。我们立即开始预防缺血性脑损伤,但仍发生了严重的脑损伤。早期诊断很有必要,并且对于麻醉管理而言,预防因血液灌注不足导致的严重脑损伤很重要。