Bedside ultrasound after aortic surgery

Abstract

Early complications after aortic surgery, such as bleeding, vessel occlusion, and organ ischemia require quick and targeted diagnostics to reduce the morbidity and mortality. Ultrasound can be used for quick bedside diagnosis of vascular and organ complications. The possibilities of color duplex and contrast-enhanced ultrasound for the detection of vascular and organ complications after aortic surgery are presented. Vascular access complications, such as acute vessel occlusion, stenosis, dissection, bleeding, hematoma, and false aneurysms can be detected by color duplex ultrasound. The differentiation between hematoma and active bleeding is possible with contrast-enhanced ultrasound. Ultrasound contrast imaging enables the evaluation of hemodynamically relevant dissections and intraluminal thrombi. Furthermore, contrast-enhanced ultrasound enables the differential diagnostics of acute kidney failure and a differentiation between complete or partial organ ischemia. The use of bedside ultrasound for quick detection of early complications after aortic surgery enables optimization of the perioperative management of complications. Further diagnostic and therapeutic interventions can be used in a targeted manner, if necessary. Unnecessary exposure to nephrotoxic radiopaque agents and X‑rays and the risks involved in transportation of critically ill patients can therefore be avoided.