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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
Summary
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.