Delayed Ascending Aortic Dissection following Off-Pump Coronary Bypass Surgery in Preexisting Stanford B Dissection
DOI:
https://doi.org/10.1532/HSF98.20101001Abstract
Delayed ascending aortic dissection following coronary artery bypass surgery is a rare but lethal complication. We present the case of a 54-year-old man with a delayed acute Stanford A aortic dissection following an off-pump coronary artery bypass surgery in preexisting chronic type B disease. Such a case of an iatrogenic acute aortic dissection poses a significant challenge and dilemma in choosing the best technique for coronary revascularization in this group of patients. The pathophysiology and technical options are discussed.References
Chavanon O, Carrier M, Cartier R, et al. 2001. Increased incidence of acute ascending aortic dissection with off-pump aortocoronary bypass surgery? Ann Thorac Surg 71:117-21.nDe Smet JM, Stefanidis C. 2003. Acute aortic dissection after off-pump coronary artery surgery. Eur J Cardiothorac Surg 24:315-7.nOzasa H, Toyota K, Uchida H, Muguruma T. 2003. Acute aortic dissection during vertical displacement of the heart in off-pump coronary artery bypass grafting (OPCAB). J Anesth 17:274-6.nPappas D, Hines GL, Gennaro M, Hartman A. 1998. Delayed iatrogenic aortic dissection from coronary bypass managed with extraanatomic bypass. J Thorac Cardiovasc Surg 115:947-9.nStanger O, Oberwalder P, Dacar D, Knez I, Rigler B. 2002. Late dissection of the ascending aorta after previous cardiac surgery: risk, presentation and outcome. Eur J Cardiothorac Surg 21:453-8.n