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Enhanced computed tomography showing dissection-like features in an extracorporeal membrane oxygenation-supported patient with no cardiac output: Can.

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Presentation on theme: "Enhanced computed tomography showing dissection-like features in an extracorporeal membrane oxygenation-supported patient with no cardiac output: Can."— Presentation transcript:

1 Enhanced computed tomography showing dissection-like features in an extracorporeal membrane oxygenation-supported patient with no cardiac output: Can acute type A aortic dissection be excluded?  Tomohiro Mizuno, MD, PhD, Keiji Oi, MD, PhD, Hirokuni Arai, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 155, Issue 4, Pages (April 2018) DOI: /j.jtcvs Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Computed tomography showing dissectionlike features. The intimal flap–like septum is also shown. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Epiaortic echography reveals slow blood flow to the patent right coronary artery and arch vessels from the retrograde perfusion of extracorporeal membrane oxygenation in the greater curvature of the aorta (dotted arrow) and blood stagnation in the lesser curvature (white arrow). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Negative finding inconsistent with acute aortic dissection. The intimal flap–like borderline lacks continuity with both the proximal and distal side (yellow arrow). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Positive computed tomographic findings of acute myocardial infarction. The intact aortic root (left, red arrow) and severe calcification of the left coronary artery (right, yellow arrow) are shown. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

6 Computed tomographic findings that resemble acute type A aortic dissection.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

7 Video 1 The video shows intraoperative epiaortic echography. Two layers of blood flow can be seen; one slows blood flow to the patent right coronary artery and arch vessels, and the other shows stagnant blood from the retrograde perfusion of percutaneous cardiopulmonary support. CT, Computed tomography. Video available at: The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

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