{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T01:08:50Z","timestamp":1769562530320,"version":"3.49.0"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Management of acute aortic dissection (AAD) caused by retrograde perfusion through the femoral artery during minimally invasive cardiac surgery (MICS) remains controversial. We present a case of AAD occurring during the late cardiopulmonary bypass (CPB) phase, which was successfully managed by vascular graft replacement, without altering the blood supply route.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>A 63-year-old man was scheduled for totally endoscopic aortic valve replacement. CPB was initiated through the right femoral artery and venous cannulation. Approximately 120\u00a0min after the initiation of CPB, mean arterial pressure and bilateral cerebral regional oxygen saturation temporarily decreased. Transesophageal echocardiography revealed type A AAD. Cerebral perfusion was preserved, allowing us to proceed to deep hypothermic circulatory arrest and successfully perform ascending aortic replacement without altering the blood supply route.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In MICS, continuous monitoring is crucial as AAD can occur at any point during CPB, and early detection enables successful outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s40981-025-00771-2","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T14:04:55Z","timestamp":1738332295000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute aortic dissection during minimally invasive cardiac surgery: a case report"],"prefix":"10.1186","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8728-0142","authenticated-orcid":false,"given":"Taisuke","family":"Kumamoto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"key":"771_CR1","doi-asserted-by":"publisher","first-page":"3050","DOI":"10.1053\/j.jvca.2020.07.084","volume":"35","author":"H Ram","year":"2021","unstructured":"Ram H, Dwarakanath S, Green AE, Steyn J, Hessel EA 2nd. Iatrogenic aortic dissection associated with cardiac surgery: a narrative review. J Cardiothorac Vasc Anesth. 2021;35:3050\u201366.","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"771_CR2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1510\/icvts.2005.114900","volume":"5","author":"T Fleck","year":"2006","unstructured":"Fleck T, Ehrlich M, Czerny M, Wolner E, Grabenwoger M, Grimm M. Intraoperative iatrogenic type A aortic dissection and perioperative outcome. Interact Cardiovasc Thorac Surg. 2006;5:11\u20134.","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"771_CR3","first-page":"1000109","volume":"2","author":"J Kennes","year":"2019","unstructured":"Kennes J, Coddens J, Van Praet F, Delahaye R. Aortic dissection in port-access cardiac surgery: a safe procedure, based on team approach, protocols and TEE. J Cardio Case Rep. 2019;2:1000109.","journal-title":"J Cardio Case Rep"},{"key":"771_CR4","doi-asserted-by":"publisher","first-page":"691","DOI":"10.21470\/1678-9741-2020-0561","volume":"36","author":"D De Viti","year":"2021","unstructured":"De Viti D, Dambruoso P, Izzo P, Dhojniku I, Raimondo P, Carbone C, et al. Iatrogenic acute aortic dissection in the era of minimally invasive cardiac surgery - experience of a center and review of literature. Braz J Cardiovasc Surg. 2021;36:691\u20139.","journal-title":"Braz J Cardiovasc Surg"},{"key":"771_CR5","doi-asserted-by":"crossref","unstructured":"Tsutsui M, Narita M, Ushioda R, Kikuchi Y, Shirasaka T, Ishikawa N, et al. A case of TEVAR for acute aortic dissection after MICS, AVR and retroperitoneal tumor resection. J Surg Case Rep. 2021;12:rjab559.","DOI":"10.1093\/jscr\/rjab559"},{"key":"771_CR6","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1007\/s10047-016-0911-z","volume":"19","author":"S Kitamura","year":"2016","unstructured":"Kitamura S, Shirota M, Fukuda W, Inamura T, Fukuda I. Numerical simulation of blood flow in femoral perfusion: comparison between side-armed femoral artery perfusion and direct femoral artery perfusion. J Artif Organs. 2016;19:336\u201342.","journal-title":"J Artif Organs"},{"key":"771_CR7","doi-asserted-by":"publisher","first-page":"100183","DOI":"10.1016\/j.medntd.2022.100183","volume":"16","author":"Y Xi","year":"2022","unstructured":"Xi Y, Li Y, Wang H, Sun A, Deng X, Chen Z, et al. The impact of ECMO lower limb cannulation on the aortic flow features under differential blood perfusion conditions. Med Novel Technol Devices. 2022;16:100183.","journal-title":"Med Novel Technol Devices"},{"key":"771_CR8","first-page":"858","volume":"67","author":"A Polat","year":"2009","unstructured":"Polat A, Mataraci I, Polat E, Tuncer A, Erentu\u011f V, Kirali K, et al. A highly fatal intraoperative urgency\u2013aortic dissection complicating heart surgery. Kardiol Pol. 2009;67:858\u201363.","journal-title":"Kardiol Pol"},{"key":"771_CR9","doi-asserted-by":"publisher","first-page":"10","DOI":"10.14797\/mdcj-12-1-10","volume":"12","author":"M Ramchandani","year":"2016","unstructured":"Ramchandani M, Al Jabbari O, Abu Saleh WK, Ramlawi B. Cannulation strategies and pitfalls in minimally invasive cardiac surgery. Methodist Debakey Cardiovasc J. 2016;12:10\u20133.","journal-title":"Methodist Debakey Cardiovasc J"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00771-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-025-00771-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00771-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T14:04:59Z","timestamp":1738332299000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-025-00771-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,31]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["771"],"URL":"https:\/\/doi.org\/10.1186\/s40981-025-00771-2","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,31]]},"assertion":[{"value":"23 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 January 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The author declares no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"6"}}