PMC8081137_01
PMC8081137_02
Mid esophageal ascending aortic long axis view - unable to visualize the dissection in the antegrade cannula site when surgeon noticed blueish discoloration
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F1
Immediate TEE assessment could not visualize the cardioplegia cannulation site in the mid-ascending aorta due to a slightly dilated aortic root causing changes in structural anatomy [Figure 1]. Alternatively, an epi-aortic ultrasound probe was used immediately which confirmed an aortic dissection at the antegrade cardioplegia cannula site using the short-axis mid ascending aorta view [Figure 2 and Video 1].
Epi-aortic ultrasound short-axis view of proximal ascending aorta - able to demonstrate dissection in the ascending aorta
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F2
Alternatively, an epi-aortic ultrasound probe was used immediately which confirmed an aortic dissection at the antegrade cardioplegia cannula site using the short-axis mid ascending aorta view [Figure 2 and Video 1].
Mid esophageal ascending aortic long-axis view - able to visualize the dissection after few minutes
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F3
During the preparation for the placement of retrograde cardioplegia line, the dissection advanced proximally toward the root and was able to be seen on TEE [Figure 3].