{"title":"Acute aortic dissection during minimally invasive cardiac surgery: a case report.","authors":"Taisuke Kumamoto","doi":"10.1186/s40981-025-00771-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Management of acute aortic dissection (AAD) caused by retrograde perfusion through the femoral artery during minimally invasive cardiac surgery (MICS) remains controversial. We present a case of AAD occurring during the late cardiopulmonary bypass (CPB) phase, which was successfully managed by vascular graft replacement, without altering the blood supply route.</p><p><strong>Case presentation: </strong>A 63-year-old man was scheduled for totally endoscopic aortic valve replacement. CPB was initiated through the right femoral artery and venous cannulation. Approximately 120 min after the initiation of CPB, mean arterial pressure and bilateral cerebral regional oxygen saturation temporarily decreased. Transesophageal echocardiography revealed type A AAD. Cerebral perfusion was preserved, allowing us to proceed to deep hypothermic circulatory arrest and successfully perform ascending aortic replacement without altering the blood supply route.</p><p><strong>Conclusions: </strong>In MICS, continuous monitoring is crucial as AAD can occur at any point during CPB, and early detection enables successful outcomes.</p>","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":"11 1","pages":"6"},"PeriodicalIF":0.8000,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JA Clinical Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40981-025-00771-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Management of acute aortic dissection (AAD) caused by retrograde perfusion through the femoral artery during minimally invasive cardiac surgery (MICS) remains controversial. We present a case of AAD occurring during the late cardiopulmonary bypass (CPB) phase, which was successfully managed by vascular graft replacement, without altering the blood supply route.
Case presentation: A 63-year-old man was scheduled for totally endoscopic aortic valve replacement. CPB was initiated through the right femoral artery and venous cannulation. Approximately 120 min after the initiation of CPB, mean arterial pressure and bilateral cerebral regional oxygen saturation temporarily decreased. Transesophageal echocardiography revealed type A AAD. Cerebral perfusion was preserved, allowing us to proceed to deep hypothermic circulatory arrest and successfully perform ascending aortic replacement without altering the blood supply route.
Conclusions: In MICS, continuous monitoring is crucial as AAD can occur at any point during CPB, and early detection enables successful outcomes.
期刊介绍：
JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.
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