Aortic dissection during transoesophageal echocardiography: a case report

Area of Science:

• Cardiology
• Medical Imaging

Background:

• Transoesophageal echocardiography (TOE) is a widely used diagnostic tool in cardiology.
• Aortic dissection is a serious condition involving a tear in the aorta's inner layer.

Purpose of the Study:

• To report a rare case of aortic dissection occurring during a transoesophageal echocardiography procedure.
• To highlight the importance of risk assessment and monitoring during TOE.

Main Methods:

• A 79-year-old woman with atrial fibrillation and a dilated ascending aorta underwent TOE.
• The procedure revealed an ascending aortic dissection shortly after probe insertion.

Main Results:

• The patient developed Stanford type A aortic dissection, extending to the iliac arteries.
• She required surgical intervention including ascending aorta replacement and coronary artery bypass graft surgery.

Conclusions:

• Transoesophageal echocardiography should be performed with adequate sedation and continuous blood pressure monitoring in patients with aortic dissection risk factors.
• The risk-benefit ratio of TOE must be carefully evaluated, and alternative imaging modalities considered when necessary.