Aortic Perforation Caused by Friction of a Chest Tube after Coronary Artery Bypass Surgery
DOI:
https://doi.org/10.1532/HSF98.20091165Abstract
Aortic perforation caused by the friction of a chest tube is a rare but life-threatening complication of coronary artery bypass grafting (CABG). We report a case involving CABG for triple-vessel disease and unstable angina. Reexploration was necessary 24 hours after the operation because of the sudden onset of pronounced bleeding. Perforation of the ascending aorta caused by friction of the chest tube was found. Bleeding was controlled by means of a purse string suture with 4-0 Prolene. Use of pericardium membrane between the heart and the chest tube and the choice of smaller and more flexible Silastic chest tubes in high-risk patients can probably reduce the incidence of this complication.References
Bjessmo S, Hylander S, Vedin J, Mohlkert D, Ivert T. 2007. Comparison of three different chest drainages after coronary artery bypass surgery—a randomised trial in 150 patients. Eur J Cardiothorac Surg 31:372-5.nKarthik S, Grayson AD, McCarron EE, Pullan DM, Desmond MJ. 2004. Reexploration for bleeding after coronary artery bypass surgery: risk factors, outcomes, and the effect of time delay. Ann Thorac Surg 78:527-34; discussion 534.nLancey RA, Gaca C, Vander Salm TJ. 2001. The use of smaller, more flexible chest drains following open heart surgery: an initial evaluation. Chest 119:19-24.nMoulton MJ, Creswell LL, Mackey ME, Rosenbloom M. 1996. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thorac Cardiovasc Surg 111:1037-46.nUnsworth-White MJ, Herriot A, Valencia O, et al. 1995. Resternotomy for bleeding after cardiac operation: a marker for increased morbidity and mortality. Ann Thorac Surg 59:664-7.n
