2020 Volume 24 Issue 1 Pages 179-182
A 60-year-old man underwent elective mitral valve replacement, tricuspid annuloplasty, and left atrial appendage occlusion. After cessation of cardiopulmonary bypass, persistent bleeding was noted from the cardioplegia injection site and ascending aortic cannulation site. The patient's blood pressure was decreased, and transesophageal echocardiography revealed dissection of the descending aorta. He was diagnosed with type A aortic dissection extending to the descending aorta based on transesophageal echocardiography and epiaortic echocardiography findings. Aortic dissection of the cardioplegia injection site was detected, and replacement of the ascending aorta was performed under deep hypothermic circulatory arrest. Transesophageal echocardiography and epiaortic echocardiography in combination proved to be an effective diagnostic tool for intraoperative aortic dissection.
