[Aortic dissection after weaning from extracorporeal circulation]

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.