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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

30
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
30
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Aneurysm I: Introduction01:30

Aneurysm I: Introduction

31
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

27
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
27
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

46
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
46

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Related Experiment Video

Updated: Sep 20, 2025

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

503

Intraoperative iatrogenic aortic dissection.

Jingge Zhao1, Hidefumi Nishida1, Ryota Nakamura1

  • 1Department of Cardiovascular Surgery, St. Luke's International Hospital, Tokyo, Japan.

Multimedia Manual of Cardiothoracic Surgery : MMCTS
|May 27, 2025
PubMed
Summary
This summary is machine-generated.

Iatrogenic aortic dissection during cardiac surgery is rare but serious. This case report details a successful repair strategy using ultrasound-guided guidewire cannulation for a dissected ascending aorta.

Keywords:
Aneurysm aortaAortic dissectionSurgical strategySurgical trainingsurgical skills

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Area of Science:

  • Cardiovascular Surgery
  • Medical Device Technology
  • Patient Safety

Background:

  • Iatrogenic aortic dissection is a rare but life-threatening complication in cardiac surgery.
  • Despite technological advancements, extreme caution is necessary during aortic procedures.

Purpose of the Study:

  • To report a case of iatrogenic aortic dissection during ascending aortic replacement.
  • To describe a successful repair strategy for intraoperative aortic injury.
  • To highlight the importance of vigilance and alternative cannulation techniques.

Main Methods:

  • An elective ascending aortic replacement was performed for an ascending aortic aneurysm.
  • Iatrogenic aortic dissection was detected intraoperatively via transesophageal echocardiography after cardiopulmonary bypass initiation.
  • Ultrasound-guided guidewire cannulation targeting the true lumen was used to re-establish cardiopulmonary bypass.

Main Results:

  • The iatrogenic aortic dissection was identified shortly after initiating cardiopulmonary bypass.
  • Cardiopulmonary bypass was successfully resumed using an alternative cannulation technique.
  • The patient recovered without complications and was discharged on postoperative day 8.

Conclusions:

  • Iatrogenic aortic dissection necessitates immediate intervention and adaptation of surgical strategy.
  • Ultrasound-guided guidewire cannulation provides a viable alternative for securing cardiopulmonary bypass in dissected aortas.
  • This case serves as a valuable educational tool for surgical fellows and emphasizes patient safety in cardiac surgery.