作者
Muhammad Salman Tahir Janjua, Shikha Shukla, Hossam Tantawy
发表日期
2021/4/1
期刊
Anesthesiology
卷号
134
期号
4
页码范围
628-628
出版商
Lippincott Williams & Wilkins
简介
In the image above, the pulsus bisferiens (panel A) developed acutely on the first postoperative day in a patient on peripherally placed extracorporeal membrane oxygenation (ECMO). ECMO was started intraoperatively because of the inability to separate from cardiopulmonary bypass because of profound vasoplegia after aortic valve replacement. Pulsus bisferiens is a feature of severe aortic regurgitation. It shows two upstrokes of arterial pressure trace during systole and wide pulse pressure may concomitantly be present. 1 A similar waveform may also be visible in hypertrophic obstructive cardiomyopathy, severe mitral valve prolapse, and sepsis. In our patient, severe aortic regurgitation was confirmed with transesophageal echocardiogram (panel B) that showed holodiastolic retrograde flow in the descending thoracic aorta and aortic regurgitation with Doppler (panel C). It is essential to promptly diagnose acute …
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MS Tahir Janjua, S Shukla, H Tantawy - Anesthesiology, 2021