Key result
Transition to general anesthesia and initiation of extracorporeal membrane oxygenation safely managed a Stanford type B acute aortic dissection that occurred during TAVI under monitored anesthesia care.
Case Report (n=1)
This case highlights the successful management of a rare and life-threatening complication (acute aortic dissection) during TAVI under monitored anesthesia care by rapidly transitioning to general anesthesia and initiating ECMO.
Alerts to rare dissection risk during MAC-TAVI; leaves open optimal anesthesia strategy in severe AS.
We report a case involving anesthetic management of Stanford type B acute aortic dissection occurred during transcatheter aortic valve implantation (TAVI) under monitored anesthesia care (MAC) in a patient with aortic stenosis (AS). An 87-year-old woman was undergoing TAVI under MAC for severe AS. During the surgery, the patient suddenly moved possibly because of pain. This was followed by hemodynamic collapse. She was then transitioned to general anesthesia, and extracorporeal membrane oxygenation (ECMO) was initiated. Transesophageal echocardiography revealed a Stanford type B acute aortic dissection, which was safely managed perioperatively with appropriate interventions.
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Okamoto et al. (2023) conducted a case report in Stanford type B acute aortic dissection during TAVI for severe aortic stenosis (n=1). Transition to general anesthesia and ECMO was evaluated on Perioperative management of acute aortic dissection. Transition to general anesthesia and initiation of extracorporeal membrane oxygenation safely managed a Stanford type B acute aortic dissection that occurred during TAVI under monitored anesthesia care.
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