We describe a case of traumatic aortic dissection associated with cardiac compression in a patient with anaphylactic cardiac arrest who underwent cardiopulmonary resuscitation (CPR). A 54-year-old man who was scheduled to undergo surgery for gastric cancer went into cardiac arrest caused by an anaphylactic reaction to prophylactic antibiotics in the operating room. Veno-arterial extracorporeal membrane oxygenation (ECMO) was performed. CPR, including chest compressions, was performed for 35 min, and the patient was transferred to the intensive care unit (ICU) after spontaneous circulation returned. The patient received ECMO for 9 hours until confirmation of normal cardiac function on transthoracic echocardiography (TTE). Twenty days after cardiac arrest, an aortic dissection and fractures in the left fourth and fifth ribs due to chest compression were detected by abdominal computed tomography. The DeBakey type III aortic dissection extended from the distal arch of the thoracic aorta to the proximal level of the renal artery, involving the celiac trunk. It was considered an uncomplicated type B aortic dissection with no sign of malperfusion of the major vessels. This case demonstrates the potential traumatic injuries that can occur after CPR and encourages proper management of mechanical complications in cardiac arrest survivors.
Citations
Citations to this article as recorded by
Blunt traumatic aortic dissection death by falling: an autopsy case report Gentaro Yamasaki, Marie Sugimoto, Takeshi Kondo, Motonori Takahashi, Mai Morichika, Azumi Kuse, Kanako Nakagawa, Yasuhiro Ueno, Migiwa Asano Forensic Science, Medicine and Pathology.2022; 19(3): 388. CrossRef
A Case of an Aortic Dissection After Mechanical Chest Compression by LUCAS Karen Ho, David Kopriva, Payam Dehghani JACC: Case Reports.2020; 2(12): 1984. CrossRef
Cardiac arrest after topical application of lidocaine during microneedling procedure: A rare case Morteza Safi, Isa Khaheshi, Fatemeh Mottaghizadeh, Mohammadreza Tabary, Nasser Malekpour Alamdari Dermatologic Therapy.2020;[Epub] CrossRef
We report a 47-year-old man who presented with acute right leg pain without any other symptoms on visit to ER. But he had the severe back pain when the leg pain developed.
Contrast CT revealed no enhancement on right common iliac artery and aortic dissection from the lower level of right renal artery to the iliac artery bifurcation. Angiographic stent insertion was performed immediately, but the patient showed reperfusion syndrome and died after 3 days. Aortic dissection with the isolated peripheral vascular complications is rare. Aortic dissection should be included in the differential diagnosis of patients with acute lower leg ischemia like peripheral arterial occlusive disease.