Clampless myocardial revascularization on a healed iatrogenic aortic dissection
Related Experiment Video
Updated: Feb 20, 2026
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Jean-David Blossier1,2, Fanny Gabrysz-Forget1,3, Victor-Xavier Tadros4
1Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Canada.
Insights
Iatrogenic aortic dissection, a rare cardiac catheterization complication, can be life-threatening. This case highlights successful conservative management followed by clampless surgical revascularization.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Iatrogenic aortic dissection is a rare but serious complication of cardiac catheterization, occurring in 0.03-0.06% of procedures.
- This complication is associated with a high mortality rate (up to 19% at 30 days) and often requires immediate surgical intervention.
Observation:
- A case of iatrogenic aortic dissection occurred during cardiac catheterization in a patient with symptomatic coronary artery disease.
- The dissection was limited and non-progressive, prompting a decision for conservative management.
Findings:
- The patient successfully underwent conservative management for the aortic dissection.
- Following conservative treatment, the patient received surgical revascularization using a clampless technique, despite the recent aortic injury.
Implications:
- This case suggests that conservative management may be a viable option for limited, non-progressive iatrogenic aortic dissections.
- The successful application of a clampless surgical technique in a patient with recent aortic injury demonstrates its potential safety and efficacy.
Abstract:
Iatrogenic aortic dissection is an infrequent complication of cardiac catheterization (0.03-0.06%) associated with up to 19% of mortality at 30 days. It was reported to mostly occur when using a 6-Fr guiding catheter to cannulate the right coronary artery. This life-threatening complication usually requires early surgical management and close imaging monitoring and control of systolic blood pressure. This case report describes a patient with iatrogenic aortic dissection during cardiac catheterization in symptomatic coronary artery disease. Conservative management of the limited non-progressive aortic dissection was chosen followed by surgical revascularization with a clampless technique, despite the recent aortic injury.
