Journal of Anesthesia

, Volume 26, Issue 4, pp 589–591 | Cite as

Acute ascending aortic intramural hematoma as a complication of the endovascular repair of a Type B aortic dissection

  • Clinton KakazuEmail author
  • Jermaine Augustus
  • Christian Paullin
  • Inderjeet S. Julka
  • Rodney A. White
Clinical Report


Endovascular aortic graft repair (EVAR) for patients with Type B aortic dissection is a less invasive surgical procedure (compared to traditional open surgical repair) that is associated with less morbidity and shortened recovery times. However, there are notable complications for the patients undergoing EVAR. We report a patient who was brought to our hospital with a Type B dissection and underwent a thoracic EVAR but suffered iatrogenic aortic injury resulting in cardiac tamponade. This case study highlights the importance of intraoperative transesophageal echocardiography to facilitate early detection of possible EVAR complications.


Aortic dissection Cardiac tamponade Endovascular surgery Transesophageal echocardiography 

Supplementary material

Supplementary Figure 1 (S1). Color Doppler TEE image of an ascending aorta intramural hematoma at the sinotubular junction (midesophageal ascending aorta short axis view). Video attached (MP4 265 kb)

Supplementary Figure 2 (S2). TEE image of acute pericardial fluid collection with ventricular compression. Video attached (MP4 237 kb)


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Copyright information

© Japanese Society of Anesthesiologists 2012

Authors and Affiliations

  • Clinton Kakazu
    • 1
    Email author
  • Jermaine Augustus
    • 1
  • Christian Paullin
    • 1
  • Inderjeet S. Julka
    • 1
  • Rodney A. White
    • 2
  1. 1.Department of Anesthesiology and Pain MedicineHarbor-UCLA Medical Center, Los AngelesTorranceUSA
  2. 2.Division of Vascular Surgery, Department of SurgeryHarbor-UCLA Medical Center, Los AngelesTorranceUSA

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