Aortic dissections complicating open cardiac surgery: report of three cases.

Abstract:

:Between June 1991 and February 1999, three patients suffered ascending aortic dissection as a complication of cardiopulmonary bypass operations with aortic cannulation at our hospital. The dissection occurred during the operation in two of the three patients and several months after the operation in one. Among a total of 2207 cardiac operations performed during this period, the incidence of perioperative ascending aortic dissection was 0.14%. In addition to visual inspection and palpation, either epicardial or transesophageal echocardiography proved extremely useful for establishing an intraoperative diagnosis of ascending aortic dissection as a complication of open cardiac operation. One of the three patients underwent closed plication but subsequently died of vital organ ischemia. In this case, failure of reapproximation of the injured intima by closed plication might have led to extension of the dissection. Despite prolonged cardiopulmonary bypass and myocardial ischemic time, graft replacement of the ascending aorta was successfully carried out in the other two patients. Thus, we believe that graft replacement of the ascending aorta should be performed for patients with extensive aortic dissection complicating an open cardiac operation.

journal_name

Surg Today

journal_title

Surgery today

authors

Aoyagi S,Tayama E,Nishimi M,Chihara S,Onizuka S,Fukunaga S

doi

10.1007/s005950070026

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

1022-5

issue

11

eissn

0941-1291

issn

1436-2813

pii

10.1007/s005950070026

journal_volume

30

pub_type

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