2017 Volume 21 Issue 1 Pages 101-104
A 60-year-old woman diagnosed with thoracoabdominal aortic aneurysm underwent reconstruction of all visceral arteries and of the right internal iliac artery under cardiopulmonary bypass and Y-shaped graft replacement. The intraoperative course was uneventful. Upon admission to the intensive care unit immediately after surgery, the patient had a pulseless electrical activity due to a drastic decrease in blood pressure. Her blood pressure was restored after the initiation of chest compression and with adrenaline intravenous infusion. Accumulation of pericardial effusion and dissection from the ascending to the descending aorta was found on transesophageal echocardiography. After retrograde dissection was discovered, the patient was immediately taken back to the operating room, where aortic arch replacement was performed. Transesophageal echocardiography was an effective diagnostic tool for postoperative hemodynamic instability.
