Acute aortic dissection during minimally invasive cardiac surgery: a case report.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-01-31 DOI:10.1186/s40981-025-00771-2

Taisuke Kumamoto

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引用次数: 0

Abstract

Background: Management of acute aortic dissection (AAD) caused by retrograde perfusion through the femoral artery during minimally invasive cardiac surgery (MICS) remains controversial. We present a case of AAD occurring during the late cardiopulmonary bypass (CPB) phase, which was successfully managed by vascular graft replacement, without altering the blood supply route.

Case presentation: A 63-year-old man was scheduled for totally endoscopic aortic valve replacement. CPB was initiated through the right femoral artery and venous cannulation. Approximately 120 min after the initiation of CPB, mean arterial pressure and bilateral cerebral regional oxygen saturation temporarily decreased. Transesophageal echocardiography revealed type A AAD. Cerebral perfusion was preserved, allowing us to proceed to deep hypothermic circulatory arrest and successfully perform ascending aortic replacement without altering the blood supply route.

Conclusions: In MICS, continuous monitoring is crucial as AAD can occur at any point during CPB, and early detection enables successful outcomes.

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微创心脏手术中急性主动脉夹层1例。

背景：微创心脏手术（MICS）中经股动脉逆行灌注引起的急性主动脉夹层（AAD）的处理仍然存在争议。我们报告了一例发生在体外循环（CPB）晚期的AAD，通过血管移植置换成功地控制了这一病例，而没有改变血液供应途径。病例介绍：一位63岁的男性被安排进行全内窥镜主动脉瓣置换术。CPB通过右股动脉和静脉插管启动。CPB开始后约120分钟，平均动脉压和双侧脑区域氧饱和度暂时下降。经食管超声心动图显示为A型AAD。脑灌注得以保留，使我们能够进行深度低温循环停搏，并在不改变血液供应途径的情况下成功进行升主动脉置换术。结论：在MICS中，持续监测是至关重要的，因为AAD可以在CPB期间的任何时候发生，早期发现可以获得成功的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.