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Reza Tavakoli
Michele Genoni
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J Thorac Cardiovasc Surg 2008;136:1364-1365
© 2008 The American Association for Thoracic Surgery

Brief Communication

Ascending aortic dissection after proximal bypass anastomotic device

Alberto Weber, MD*, Reza Tavakoli, MD, Jurg Gruenenfelder, MD, Michele Genoni, MD

Department for Cardiovascular Surgery, University Hospital, Zurich, Switzerland

Received for publication December 4, 2006; accepted for publication December 12, 2006.

* Address for reprints: Alberto Weber, MD, Zurich University Hospital, Cardiovascular Surgery, Raemistrasse 100, 8091 Zurich, Switzerland. (Email: alberto.weber@usz.ch).

The first 20% of the full text of this article appears below.

Aortic dissection is a rare complication of cardiac operations that is associated with surgical maneuvers such as the placement of the proximal anastomosis and carries a high mortality rate.1,2Go To maintain the quality of care for patients undergoing off-pump coronary artery bypass grafting (OPCAB), a no-touch technique of the ascending aorta is important. If that is not possible, it is important to perform the proximal anastomoses on the aorta with a no-clamp technique.3Go

Clinical Summary

A 79-year-old man with unstable angina (Canadian Cardiovascular Society class IV and New York Heart Association functional class IV) was referred to our center for coronary angiography. The patient's vascular risk factors included nicotine use, dyslipidemia, arterial hypertension, and diabetes. He also had peripheral arterial vascular disease with a known aneurysm of the descending thoracic aorta. In addition, an aortobifemoral graft and a femoropopliteal bypass had been implanted 5 years previously to treat an infrarenal abdominal aneurysm and a persistent claudication (grade IIb). In the preoperative computed tomographic scan, the ascending aorta showed a maximal diameter of 3.9 cm and arteriosclerotic plaques over the aortic arch. Cardiac catheterization . . . [Full Text of this Article]






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