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Acute aortic dissection after off-pump coronary artery surgery

Jean-Marie De Smet1, Constantin Stefanidis

  • 1Service of Cardiac Surgery, Erasme Hospital, Free University of Brussels, 808 Route de Lennik, B-1070 Brussels, Belgium. jean-marie.de.smet@ulb.ac.be

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|August 5, 2003
PubMed

Insights

Iatrogenic aortic dissection is a rare complication after coronary artery surgery. A recent case highlights the risk of aortic dissection and paraplegia following off-pump coronary artery bypass grafting, even without cardiopulmonary bypass.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • Iatrogenic aortic dissection is an infrequent complication associated with coronary artery surgery.
  • The introduction of beating heart surgery has been linked to a potential increase in this complication.
  • Aortic clamping during proximal anastomosis in off-pump procedures is a suspected cause.

Observation:

  • A 70-year-old patient underwent off-pump coronary artery surgery.
  • The patient developed an aortic dissection.
  • The dissection resulted in immediate paraplegia.

Findings:

  • The patient presented with aortic dissection and paraplegia seven days after off-pump coronary artery surgery.
  • This case underscores the potential risks of aortic manipulation during beating heart procedures.
  • The complication occurred despite the absence of cardiopulmonary bypass.

Implications:

  • Surgeons should be vigilant regarding aortic injury risks during off-pump coronary artery surgery.
  • Further research may be needed to refine techniques and minimize aortic complications.
  • This case highlights a serious neurological complication following aortic dissection in this surgical context.

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