Early Postoperative Iatrogenic Acute Type-A Aortic Dissection Following Off-pump Coronary Artery Bypass Graft Surgery: An Uncommon Complication of a Common Surgery

Abstract

Complications of cardiac surgery include iatrogenic acute aortic dissection (IAAD), which occurs in 0.04%–0.06% of cases and has poorer results than spontaneous dissection. IAADs generated by thoracotomy are often associated with severe cardiovascular conditions, such as advanced atherosclerosis with three or more coronary artery lesions and persistent heart failure due to multivalvular heart disease. It is possible to experience this complication following any kind of cardiac surgery, including off-pump coronary artery bypass grafting (OPCAB) as well as following endovascular operations. We encountered early postoperative IAAD following OPCAB, which necessitated high-risk reoperation with dismal outcomes. Death rates could be reduced with better access to timely diagnosis and adequate treatment. Avoiding, diagnosing, and treating this potentially fatal complication requires tremendous effort from every member of the heart team.