How can aortic dissection caused by the aortic cannula be detected when using a roller pump?

Detecting aortic dissection during cardiopulmonary bypass, particularly when using a roller pump, is critical for ensuring patient safety and effective management during surgery. The most effective indicator among the choices is elevated arterial line pressure.

When an aortic dissection occurs, it can create an intramural hematoma or separate layers of the aorta, affecting blood flow dynamics. This change can result in significant alterations in arterial pressure readings. An elevated arterial line pressure signifies that there is increased resistance or obstruction within the aortic arch or systemic circulation, which may be a result of the dissection process. As the pump generates flow and pressure, the presence of an obstruction (such as from a dissection flap) would manifest as a rise in the pressure recorded from the arterial line.

Monitoring this pressure is crucial because the data can guide immediate clinical decisions, potentially allowing for intervention before the situation escalates.

The other factors such as elevated venous return, elevated left radial artery pressure, and increased venous saturation don't provide the direct and immediate evidence of an aortic dissection as effectively as the monitoring of arterial line pressure. Elevated venous return might indicate other hemodynamic changes, while increased saturation or pressure in peripheral arteries might be influenced by