Abstract
An 80-year-old man with the diagnosis of acute aortic dissection was rushed to the emergency department. Preoperative transthoracic echocardiography showed pericardial effusion and mild aortic regurgitation; however, the mitral valve was not observed. Although the false lumen was thrombosed, emergency surgery was performed because of the patient’s severe hypotension. After induction of general anesthesia, transesophageal echocardiography was performed to evaluate cardiac function. Transesophageal echocardiography showed a thickened basal interventricular septum, severe mitral regurgitation, and anterior systolic motion of the anterior mitral leaflet, in addition to pericardial effusion and mild aortic regurgitation.
In emergency cardiovascular surgery, there may not be sufficient time to assess cardiac function. Because new findings that have not been diagnosed preoperatively may influence treatment decisions, it is important to evaluate the entire heart by intraoperative transthoracic echocardiography in addition to the sitestargeted for surgical intervention.
