Intraoperative Epiaortic Ultrasound for Traumatic Pseudoaneurysm of the Ascending Aorta

Abstract

Epiaortic ultrasound is an imaging modality that is commonly used to evaluate the ascending aorta for atheroma and other mural lesions during elective cardiac surgery. Its use in contained aortic rupture has not been established. We present a case of thoracic trauma with contained pseudoaneurysm of the ascending aorta. At operation, the precise location of the aortic tear could not be identified by visual inspection, manual palpation, or transesophageal echocardiography. Epiaortic ultrasound was employed and the aortic defect was identified and successfully repaired. This intraoperative imaging modality may play an increasing role in the identification of aortic pathology when visual inspection and other intraoperative imaging is insufficient.

Iatrogenic Aortic Pseudoaneurysm After an Aortic Valve Replacement Requiring Emergency Reoperation

“…This case illustrated several points: need for high index of diagnostic suspicion in patients with multiple risk factors for intraoperative aortic injury, essential role of intraoperative TEE and epiaortic scanning in evaluating and monitoring the aortic cannulation sites for iatrogenic defects, and strong indication for aortic repair with cardiopulmonary bypass in cases of intramural hematoma in the ascending aorta even in the apparent absence of bloodflow communication. 4…”