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Perioperative transesophageal echocardiography for aortic dissection

  • Christine N. H. TanEmail author
  • Alan G. Fraser
Review Article/Brief Review

Abstract

Purpose

Aortic dissection is an infrequent but serious condition that often requires immediate operative intervention. We explore recent developments in the classification of aortic dissection and perioperative transesophageal echocardiography that assist with quantifying the severity of disease and facilitate its management.

Principal findings

We describe the pivotal role of echocardiography in relation to key surgical considerations such as cannulation, aortic root surgery, perfusion in the aortic arch vessels, stenting in hybrid arch repair, and timing of preventative surgery.

Conclusion

Developments in the classification of aortic dissection have improved our perspective and understanding of the key presenting features that affect mortality. Improvements in patient outcome may be achieved in part by appropriately timed echocardiography-guided surgery.

Keywords

Aortic Valve Aortic Dissection Aortic Root Aortic Regurgitation Left Subclavian Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

L’échocardiographie transœsophagienne périopératoire lors d’une dissection aortique

Résumé

Objectif

La dissection aortique est une maladie peu fréquente mais grave qui nécessite souvent une intervention opératoire immédiate. Nous explorons les développements récents survenus dans la classification de la dissection aortique et l’utilisation de l’échocardiographie transœsophagienne périopératoire pour aider à quantifier la gravité de la maladie et faciliter sa prise en charge.

Constatations principales

Nous décrivons le rôle-charnière de l’échocardiographie en relation avec diverses considérations chirurgicales clés, notamment la canulation, la chirurgie de la racine aortique, la perfusion des vaisseaux de l’arc de l’aorte, l’implantation d’endoprothèse pour la réparation hybride de l’arc, et le choix du moment opportun pour la chirurgie de prévention.

Conclusion

Les développements survenus dans la classification de la dissection aortique ont amélioré notre perspective et notre compréhension des caractéristiques de présentation clés qui affectent la mortalité. Des améliorations au niveau des pronostics des patients pourraient survenir en partie grâce à une chirurgie échoguidée planifiée au moment opportun.

Notes

Conflicts of interest

None declared.

Funding

No financial support was given, but the time needed to write this article was provided by the Department of Anaesthesia, University Hospital of Wales, Cardiff. This work is attributed to the Department of Anaesthesia, University Hospital of Wales and the Wales Heart Research Institute, Cardiff, United Kingdom. The work has not been presented at any meetings and no individual acknowledgement is necessary.

Supplementary material

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Copyright information

© Canadian Anesthesiologists' Society 2014

Authors and Affiliations

  1. 1.Department of Anaesthesia, Critical Care and Pain Management, B3University Hospital of WalesCardiffUK
  2. 2.Wales Heart Research InstituteCardiff UniversityCardiffUK

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