Acute aortic dissection during minimally invasive cardiac surgery: a case report

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 successfu...

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Main Author: Taisuke Kumamoto
Format: Article
Language:English
Published: SpringerOpen 2025-01-01
Series:JA Clinical Reports
Subjects:
Online Access:https://doi.org/10.1186/s40981-025-00771-2
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author Taisuke Kumamoto
author_facet Taisuke Kumamoto
author_sort Taisuke Kumamoto
collection DOAJ
description 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.
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spelling doaj-art-869354bea0974cdf945ae0186c9371752025-02-02T12:12:24ZengSpringerOpenJA Clinical Reports2363-90242025-01-011111410.1186/s40981-025-00771-2Acute aortic dissection during minimally invasive cardiac surgery: a case reportTaisuke Kumamoto0Department of Anesthesiology, Saiseikai Kumamoto HospitalAbstract 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.https://doi.org/10.1186/s40981-025-00771-2Minimally invasive cardiac surgeryAcute aortic dissectionTransesophageal echocardiographyCardiopulmonary bypassRetrograde perfusion
spellingShingle Taisuke Kumamoto
Acute aortic dissection during minimally invasive cardiac surgery: a case report
JA Clinical Reports
Minimally invasive cardiac surgery
Acute aortic dissection
Transesophageal echocardiography
Cardiopulmonary bypass
Retrograde perfusion
title Acute aortic dissection during minimally invasive cardiac surgery: a case report
title_full Acute aortic dissection during minimally invasive cardiac surgery: a case report
title_fullStr Acute aortic dissection during minimally invasive cardiac surgery: a case report
title_full_unstemmed Acute aortic dissection during minimally invasive cardiac surgery: a case report
title_short Acute aortic dissection during minimally invasive cardiac surgery: a case report
title_sort acute aortic dissection during minimally invasive cardiac surgery a case report
topic Minimally invasive cardiac surgery
Acute aortic dissection
Transesophageal echocardiography
Cardiopulmonary bypass
Retrograde perfusion
url https://doi.org/10.1186/s40981-025-00771-2
work_keys_str_mv AT taisukekumamoto acuteaorticdissectionduringminimallyinvasivecardiacsurgeryacasereport