Intraoperative Transesophageal Echocardiography in Acute Type A Aortic Dissection: Contemporary Approach - 03/06/25
, Andrej Alfirevic, MD a, Mariya Geube, MD a, Andrew Bauer, MD a, Nikolaos J. Skubas, MD b, Luai Zakaria, MD a, Eric E. Roselli, MD b, Patrick R. Vargo, MD b, Faisal G. Bakaeen, MD b, Xiaoying Lou, MD b, Lars G. Svensson, MD b, Marijan Koprivanac, MD, MS bAbstract |
Acute type A aortic dissection represents a critical cardiac surgical emergency and carries a significant mortality risk. While computed tomography angiography is the standard for initial diagnosis, transesophageal echocardiography (TEE) is indispensable in the intraoperative setting. This article discusses intraoperative TEE findings in patients undergoing surgery for type A aortic dissection, emphasizing the necessity of real-time imaging to detect complications and guide surgical management. The use of TEE is important in confirming diagnoses, monitoring hemodynamics, evaluating the function of the aortic valve, pericardial, and pleural spaces, and potentially assessing abdominal branch vessel flow, thus ultimately facilitating informed surgical decisions. Moreover, intraoperative TEE use enables differentiation between true and false lumens and facilitates central aortic cannulation guidance via the Seldinger technique. Post–cardiopulmonary bypass, TEE is used to assess surgical results and guide further interventions if necessary. This comprehensive review aims to disseminate essential echocardiographic insights, advocating for greater awareness and utilization of TEE in the surgical management of aortic dissection to improve patient outcomes.
Le texte complet de cet article est disponible en PDF.Central Illustration |
XXX.
Transesophageal echocardiography in acute type A dissection; intraoperative assessment and central cannulation guidance.
Central IllustrationTransesophageal echocardiography in acute type A dissection; intraoperative assessment and central cannulation guidance.Le texte complet de cet article est disponible en PDF.
Highlights |
• | TAAD is confirmed intraoperatively by identifying the dissection flap and entry tears. |
• | TEE is crucial for monitoring hemodynamics in cases of TAAD complications. |
• | AV function can be assessed intraoperatively, guiding decisions on possible repair. |
• | TEE helps in analyzing the flow characteristics of abdominal branch vessels. |
• | Differentiation of true vs false lumens is critical in guiding surgery. |
Keywords : Acute aortic dissection, Type A, Ascending aorta, Intraoperative transesophageal echocardiography
Abbreviations : AI, AV, CPB, CT, CTA, FET, LV, RV, TAAD, TEE
Plan
| This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. |
Vol 38 - N° 6
P. 498-508 - juin 2025 Retour au numéro
Article précédent
- Clinical Risk Predictors for Abnormal Left Ventricular and Atrial Function in Lupus Erythematosus
- Matteo Morello, Bethany Gholson, Weiting Huang, William Lain, Maxwell Malter, Antonio Abbate, Brittany N. Weber, Jonathan R. Lindner
- Elevated Systolic Blood Pressure and Hemodynamic Parameters in Patients With Aortic Stenosis Undergoing Echocardiography in Real-World Practice
- Jaiveer Singh, Samuel W. Reinhardt, David J. Hur, Lissa Sugeng, Emmanuel Akintoye, Bernardo Lombo, Lavanya Bellumkonda, Evgeny Shkolnik, Robert L. McNamara, Kamil F. Faridi
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?