Related Experiment Video
Updated: Oct 9, 2026

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
Increased incidence of acute ascending aortic dissection with off-pump aortocoronary bypass surgery?
O Chavanon1, M Carrier, R Cartier
1Department of Surgery, Research Center, Montreal Heart Institute, Quebec, Canada.
Background:
An apparent increase in the incidence of acute ascending aortic dissection following off-pump coronary artery bypass grafting (OPCAB) led us to assess retrospectively the rate and circumstances of this complication in our institution on a consecutive series of patients undergoing aortocoronary bypass performed with and without extracorporeal circulation (ECC).
Methods:
A retrospective analysis of acute ascending aortic dissections complicating coronary artery bypass grafting surgery in 3,031 patients in our institution since April 1, 1995, was performed using the database of the Montreal Heart Institute.
Results:
There was a greater frequency of hypertension in the OPCAB group. Iatrogenic acute aortic dissection occurred in 3 patients among 308 operated on without ECC (0.97%) and 1 patient among 2,723 operated on under ECC (0.04%). This difference was statistically significant (p < 0.00001).
Conclusions:
The risk of aortic dissection may be increased in OPCAB. Careful manipulation of the aorta with a single side-clamping and a control of the arterial pressure should be used to minimize aortic trauma. High-risk patients should undergo CABG without side-clamping of the aorta or CABG with ECC to prevent this redoubtable complication of myocardial revascularization.
Related Concept Videos
Aneurysm IV: Nursing Management
Aneurysm III: Interprofessional Care
Aortic Regurgitation I: Introduction
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Aortic Regurgitation III: Medical Management
