{
    "abstract": "Iatrogenic aortic dissection (IAD) is a life-threatening condition, primarily caused by arterial cannulation during cardiopulmonary bypass (CPB) in cardiac surgeries. Transesophageal echocardiography (TEE) is the first-line diagnostic tool in the acute setting, but the presence of several artifacts can easily lead to misinterpretation. A 55-year-old man underwent coronary artery bypass grafting and implantation of central veno-arterial extracorporeal membrane oxygenation (V-A ECMO). TEE revealed what appeared to be an intimal dissection flap in the aortic arch and descending thoracic aorta, raising concerns for an IAD, which was not confirmed by computed tomographic angiography. This case highlights the pitfalls and limitations of echocardiography in the diagnosis of IAD, especially in settings with complex flow patterns such as during CPB or V-A ECMO.",
    "authors": [
        {
            "affiliation": "Cardiac Surgery and Heart Transplant Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.\nCardiology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.",
            "firstname": "Ludovica",
            "initials": "L",
            "lastname": "De Fazio"
        },
        {
            "affiliation": "Cardiac Surgery and Heart Transplant Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.",
            "firstname": "Amedeo",
            "initials": "A",
            "lastname": "Pergolini"
        },
        {
            "affiliation": "Cardiac Surgery and Heart Transplant Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.",
            "firstname": "Giulio",
            "initials": "G",
            "lastname": "Cacioli"
        },
        {
            "affiliation": "Cardiac Surgery and Heart Transplant Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.",
            "firstname": "Guglielmo",
            "initials": "G",
            "lastname": "Saitto"
        },
        {
            "affiliation": "Anesthesiology and Intensive Care Unit, Cardio-Thoracic-Vascular Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.",
            "firstname": "Alessandro",
            "initials": "A",
            "lastname": "Centonze"
        },
        {
            "affiliation": "Cardiac Surgery and Heart Transplant Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.",
            "firstname": "Carlo",
            "initials": "C",
            "lastname": "Contento"
        },
        {
            "affiliation": "Cardiac Surgery and Heart Transplant Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.",
            "firstname": "Fabio",
            "initials": "F",
            "lastname": "Sbaraglia"
        },
        {
            "affiliation": "Anesthesiology and Intensive Care Unit, Cardio-Thoracic-Vascular Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.",
            "firstname": "Emilio",
            "initials": "E",
            "lastname": "D'Avino"
        },
        {
            "affiliation": "Cardiac Surgery and Heart Transplant Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.",
            "firstname": "Federico",
            "initials": "F",
            "lastname": "Ranocchi"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024 Wiley Periodicals LLC.",
    "doi": "10.1111/echo.70043",
    "journal": "Echocardiography (Mount Kisco, N.Y.)",
    "keywords": [
        "artifacts",
        "cardiopulmonary bypass",
        "iatrogenic aortic dissection",
        "intra\u2010operative transesophageal echocardiography",
        "veno\u2010arterial extracorporeal membrane oxygenation"
    ],
    "methods": null,
    "publication_date": "2024-12-03",
    "pubmed_id": "39624930",
    "results": null,
    "title": "Suspected Iatrogenic Aortic Dissection During Cardiopulmonary Bypass and Veno-Arterial Extracorporeal Membrane Oxygenation: A Challenging Dilemma.",
    "xml": "<Element 'PubmedArticle' at 0x788503dd9120>"
}