Descending aortic thrombosis and acute type B dissection during central extracorporeal membrane oxygenation: A word of caution

Figures

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  Thrombus cast (A) and type B aortic dissection and intimal flap (B).

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  Figure 1. Chest radiograph on admission to our hospital. The patient was intubated and supported on both central extracorporeal membrane oxygenation and intra-aortic balloon pump. White arrows indicate the entire arterial cannula placed in the descending aorta. A mechanical mitral valve is also seen at the tip of the cannula.

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  Video 1. Summary of our case report including aortic cannulation and imaging findings. Video available at: https://www.jtcvs.org/article/S2666-2507(20)30645-3/fulltext.

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  Figure 2. Postoperative transesophageal echocardiography shows (A) thrombus cast where the arterial cannula is in the descending aorta and (B) type B aortic dissection and intimal flap confirmed by the short- and long-axial views. The intimal flap is confined to thorax and not observed at the site of the aortic cannulation (ascending aorta). The intimal flap does not cover the visceral arteries, either.