术中经食管超声心动图诊断升主动脉夹层1例  

Diagnosis of ascending aortic dissection by intraoperative transesophageal echocardiography: a case report

作　　者：张重[1] 李龙艳[1] 王锷[1] Zhang Zhong;Li Longyan;Wang E(Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008, China)

机构地区：[1]中南大学湘雅医院麻醉科,长沙410008

出　　处：《国际麻醉学与复苏杂志》2019年第8期765-767,共3页International Journal of Anesthesiology and Resuscitation

摘　　要：升主动脉夹层是危及生命的急危重症,一旦诊断,则应该进入绿色通道进行相应的诊治。而升主动脉夹层的诊断金标准为CT主动脉全长成像。文章报道1例患者术前进行主动脉多层螺旋CT血管成像检查,且常规进行经胸超声心动图检查,未发现升主动脉根部夹层,而在术中经食管超声心动图(transesophageal echocardiography, TEE)发现了升主动脉根部夹层,累及右冠状动脉开口,及时调整主动脉插管位置以及手术方案,患者预后良好。总结该病例经验,以为该类患者避免漏诊升主动脉根部夹层提供参考。Ascending aortic dissection is a life-threatening disease. Once diagnosed, patients should be immediately managed for appropriate diagnosis and treatment. The golden standard for diagnosis of ascending aortic dissection is computer tomography (CT) aortic full-length imaging. However, this patient underwent preoperative tests of CT aortic full-length imaging and routine transthoracic ultrasonography. But diagnosis of ascending aortic dissection was ignored. The root of ascending aortic dissection was found by transesophageal echocardiography during operation. The aortic dissection involved the opening of the right coronary artery the position of aortic perfusing intubation and surgical plan were adjusted in time. The prognosis of the patient was good. This case provided experiences in avoiding missed diagnosis of aortic dissection in patients with ascending aortic aneurysm.

关 键 词：经食管超声心动图 升主动脉 主动脉夹层 

分 类 号：R614[医药卫生—麻醉学]