Acute type A aortic dissection with a tear in the posterior wall of the ascending aorta early after off-pump coronary artery bypass grafting.
Gen Thorac Cardiovasc Surg
; 69(5): 870-873, 2021 May.
Article
in En
| MEDLINE
| ID: mdl-33201384
ABSTRACT
The patient was a 68-year-old man who underwent triple-vessel OPCAB uneventfully with aortic proximal anastomosis at one site using the saphenous vein with a mechanical device, not a side clamp, with mild traction of the ascending aorta by aortic taping. On postoperative day 7, computed tomography revealed extremely localized AAD with a tear on the posterior wall of the ascending aorta. Emergent ascending aortic replacement was successfully performed. Surprisingly, the tear extended laterally along the traction site of the tape. To our knowledge, this is the first report of AAD early after OPCAB originating at a location other than the sites of proximal anastomosis or side clamping. Proximal anastomosis with a mechanical device to the towed aorta may indirectly or directly injure the intima of the posterior wall, causing this complication. Manipulating the aorta under abnormal pressure should be avoided.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Bypass, Off-Pump
/
Aortic Dissection
Limits:
Aged
/
Humans
/
Male
Language:
En
Journal:
Gen Thorac Cardiovasc Surg
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2021
Document type:
Article
Affiliation country:
Japón