Intraoperative TEE to guide aortic cannulation

Intraoperative TEE can be used to guide aortic cannulation for cardiopulmonary bypass in a patient with aortic dissection to ensure that the TL of the aorta is cannulated. TEE short-axis image of the aortic arch (left panel) showed that the arterial guidewire (arrow) was inadvertently inserted into the FL of the aortic dissection. TEE short-axis image of the descending thoracic aorta in another patient with an acute aortic dissection showed proper position of the arterial guidewire in the TL of the aortic dissection.