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Intra-operative Transoesophageal Echocardiography Detecting Intramural Haematoma During Thoracic Endovascular Aortic Repair

  • Jun Pan
    Affiliations
    Department of Vascular Surgery, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China
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  • Ziheng Wu
    Correspondence
    Corresponding author. Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Shangcheng District, Hangzhou, Zhejiang 310003, China.
    Affiliations
    Department of Vascular Surgery, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China
    Search for articles by this author
Published:August 09, 2022DOI:https://doi.org/10.1016/j.ejvs.2022.07.054
      Image 1
      A 49 year old man with type B aortic dissection underwent thoracic endovascular aortic repair (TEVAR) with left carotid and subclavian artery fenestrations. After stent graft deployment, intra-operative transoesophageal echocardiography detected hypoechoic, well defined, crescent shaped wall thickening without a dissection flap in the ascending aorta via the short axis (A, white arrow). The M mode showed that the aortic wall thickening remained constant during the cardiac cycle. Doppler mode showed no communication between the aortic lumen and the thickening aortic wall (B). Ultrasound revealed the intramural haematoma. Two weeks following TEVAR, computed tomography angiography indicated that the intramural haematoma had progressed into type A aortic dissection. The patient underwent open surgery.
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