Aortic root dissection complicating coronary bypass surgery

Nicholson, William J.; Crawley, I.Sylvia; Logue, R. Bruce; Dorney, Edward R.; Cobbs, B.Woodfin; Hatcher, Charles R.

doi:10.1016/0002-9149(78)90139-x

Cited by 44 publications

(19 citation statements)

References 18 publications

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“…However, there are some studies that demonstrated the occurrence of aortic dissection in the late postoperative period of patients undergoing CABG. In the aortas were observed atheroma plaques, wall dilatation, cystic necrosis and collagen disease [3,4]. The patient in this case report is dyslipidemic, which possibly led to the presence of the atheroma plaque in the ascending aorta and caused the aortic dissection.…”

Section: Discussionmentioning

confidence: 86%

O tratamento operatório da dissecção aórtica crônica tipo A em pacientes submetidos à revascularização cirúrgica do miocárdio

Leal

Ferreira²,

Avanci

et al. 2010

Rev Bras Cir Cardiovasc

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Section: Discussionmentioning

confidence: 86%

O tratamento operatório da dissecção aórtica crônica tipo A em pacientes submetidos à revascularização cirúrgica do miocárdio

Leal

Ferreira²,

Avanci

et al. 2010

Rev Bras Cir Cardiovasc

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“…Each manipulation could cause disruption of the intima or the ascending aorta, resulting in pseudoaneurysm [2] or acute dissection [3]. Acute dissection of the ascending aorta, occurring simultaneously with or immediately after CABG surgery, and its management has been reported [1][2][3]. However, acute aortic dissection occurring late after the initial cardiac surgery has rarely been reported [3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…It can be reasonably assumed that dissection of the ascending aorta occurs in a weakened part of the intima of the aortic wall associated with the proximal anastomoses. It has been reported that uncontrolled hypertension is a major risk factor in the causation of aortic dissection after open heart operations [2,3].…”

Section: Discussionmentioning

confidence: 99%

“…Dissection of the ascending aorta during coronary artery bypass grafting (CABG) is an uncommon but welldocumented complication [1][2][3]. However, ascending aortic dissection occurring late after CABG is rare [3][4][5][6], and only a few cases have been published in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…However, ascending aortic dissection occurring late after CABG is rare [3][4][5][6], and only a few cases have been published in the literature. Furthermore, no specific guidelines exist regarding optimal management.…”

Section: Introductionmentioning

confidence: 99%

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Late acute aortic dissection after coronary artery bypass

Shinfeld

Raanani

2008

Langenbecks Arch Surg

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We assume that postoperative pericardial scarring and adhesions provide some protection against progression of the dissection and therefore suggest that preferred treatment in non-stable patients should be surgical. In stable patients, close follow-up and blood pressure control are beneficial. Late ascending aortic dissection after CABG is rare, and treatment presents a clinical dilemma. We treated eight patients with post-CABG late acute aortic dissection. Three underwent surgical replacement of the ascending aorta. One died after surgery, and the other two had an uneventful recovery. Five patients were treated conservatively. No standard treatment guidelines exist for late acute aortic dissection after CABG. We assume that postoperative pericardial scarring and adhesions provide some protection against progression of the dissection, and suggest that preferred treatment in non-stable patients should be surgical. In stable patients, close follow-up and blood pressure control are beneficial.

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Iatrogenic aorto‐sinus of Valsalva fistula: Angiographic and cine computerized tomography delineation

Blaker

Marchena

Hansen

et al. 1990

Cathet. Cardiovasc. Diagn.

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A patient is reported who underwent cardiac catheterization 4 years following coronary artery bypass grafting. Cardiac catheterization revealed the presence of a fistulous tract in the wall of the ascending aorta, originating at the site of aortic anastomosis of a saphenous vein bypass graft and ending in the superior aspect of the right sinus of Valsalva. This complication was felt to have resulted from a inadvertent localized dissection of the aorta during bypass surgery. The fistula was also imaged by ultrafast cine computerized tomography which proved a useful non-invasive method for follow-up examination.

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Aortic root dissection complicating coronary bypass surgery

Cited by 44 publications

References 18 publications

O tratamento operatório da dissecção aórtica crônica tipo A em pacientes submetidos à revascularização cirúrgica do miocárdio

O tratamento operatório da dissecção aórtica crônica tipo A em pacientes submetidos à revascularização cirúrgica do miocárdio

Late acute aortic dissection after coronary artery bypass

Iatrogenic aorto‐sinus of Valsalva fistula: Angiographic and cine computerized tomography delineation

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