Eight-year experience of intraoperative aortic dissection

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Aortic dissection is a severe complication following cardiac operations.
• Early diagnosis and management are crucial for patient outcomes.

Purpose of the Study:

• To determine the incidence of aortic dissection during elective cardiac surgery.
• To evaluate the utility of intraoperative transesophageal echocardiography (TEE) in diagnosing and managing aortic dissection.

Main Methods:

• Retrospective analysis of adult patients undergoing elective cardiac surgery with TEE monitoring over 8 years.
• Identification and classification of aortic dissection cases.

Main Results:

• Aortic dissection occurred in 7 (0.13%) of 5,247 patients, all Type A.
• TEE diagnosed 5 cases immediately and 2 later; dissections occurred post-procedure.
• Conservative treatment resulted in death within 5 days for 2 patients.
• 5 patients undergoing immediate reoperation survived with significant postoperative complications.

Conclusions:

• Intraoperative TEE is valuable for diagnosing aortic dissection during cardiac operations, particularly involving the ascending aorta.
• Prompt diagnosis and treatment, especially with TEE, can improve outcomes and avoid delayed management.
• TEE should be considered in at-risk patients to prevent missed diagnoses and treatment delays.