Anesthetic management of Stanford type B acute aortic dissection that occurred during transcatheter aortic valve implantation under monitored anesthesia care: A case report

Shusuke Okamoto; Takuya Okada; Norihiko Obata; Yu Yamane; Koichiro Masada; Masahiko Iseki; Masaharu Nagae

doi:10.1016/j.heliyon.2023.e21278

Anesthetic management of Stanford type B acute aortic dissection that occurred during transcatheter aortic valve implantation under monitored anesthesia care: A case report

Heliyon. 2023 Oct 20;9(11):e21278. doi: 10.1016/j.heliyon.2023.e21278. eCollection 2023 Nov.

Authors

Shusuke Okamoto¹, Takuya Okada², Norihiko Obata², Yu Yamane¹, Koichiro Masada¹, Masahiko Iseki¹, Masaharu Nagae¹

Affiliations

¹ Department of Anesthesiology and Pain Clinic, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiya-cho, Himeji, 670-8560, Japan.
² Division of Anesthesiology, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.

Abstract

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.

Keywords: Aortic stenosis; Case report; Extracorporeal membrane oxygenation; Stanford type B acute aortic dissection; Transcatheter aortic valve implantation under monitored anesthesia care.

Publication types

Case Reports