Retrograde Aortic Dissection Occurring During Cardiopulmonary Bypass

Bilgutay, Aydin M.; Garamella, Joseph J.; Danyluk, Michael; Remucal, Honorato C.

doi:10.1001/jama.1976.03270050021022

Cited by 13 publications

(1 citation statement)

References 6 publications

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“…Table 1 presents the descriptive analysis of these cases. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The 27 patients were aged 50 to 81 years, 25 (93%) males and 2 (7%) females. Among the patients, 23 (85%) were Europeans and 4 (15%) were Asians.…”

Section: Resultsmentioning

confidence: 99%

Iatrogenic aortic dissection in patients undergoing coronary artery bypass grafting surgery: A systemic review of published literatures

Yuan,

Sun,

Chen

et al. 2024

Medicine

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Background: Iatrogenic aortic dissection (IAD) is a rare but highly lethal complication that may occur following coronary artery bypass grafting (CABG) surgery. Aortic dissection (AD) is often asymptomatic, making early detection difficult. We aimed to optimize preoperative evaluation strategies of CABG surgery for minimizing the incidence of IAD and assess early recognition and management of IAD for improving outcomes. Methods: Electronic databases were searched to identify all case reports of patients undergoing CABG surgery who developed IAD. Clinical characteristics, operative information, perioperative management, and patient outcomes were compiled and analyzed. Results: Nineteen case reports involving 27 patients aged 50 to 81 were included. Patients were from Europe (n = 23) and Asia (n = 4), mostly men (n = 25). The aorta was described as normal, abnormal, and unmentioned (n = 8, 5, and 14, respectively). Sixteen patients had a bypass with more than 3 grafts. Most patients (n = 25) experienced type A dissection. There were intraoperative (n = 12) and postoperative (n = 15) cases. Surgery (n = 19) was the most common treatment, with 9 patients selecting deep hypothermic circulatory arrest. Eighteen patients were restored to health, while 9 patients died (3 died before treatment). Conclusions: Our study focused on patients with IAD and developed a recommended management protocol for patients undergoing CABG surgery.

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Section: Resultsmentioning

confidence: 99%

Iatrogenic aortic dissection in patients undergoing coronary artery bypass grafting surgery: A systemic review of published literatures

Yuan,

Sun,

Chen

et al. 2024

Medicine

View full text Add to dashboard Cite

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Retrograde aortic dissection during cardiopulmonary bypass

Eugene

Aronow

Stemmer

1981

Clinical Cardiology

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Summary: Femoral artery perfusion for cardiopulmonary bypass is still employed for reoperation, procedures involving the thoracic aorta, and partial bypass in critical patients. Retrograde aortic dissection is the most significant complication of femoral perfusion. The reported incidence is from 0.6% to 14% with a mortality of 66%. Most of the deaths occurred in patients in whom the dissection was not recognized, or in whom the dissection was recognized but not treated appropriately. Our experience with retrograde dissection totals six patients of 640 (0.9%) in whom femoral inflow was used. Four of the six patients survived the dissection. Sudden increase in extracorporeal line pressure shortly after beginning cardiopulmonary bypass associated with decreased venous return, dampened radial arterial pressure, and the abrupt appearance of a bluish, bulging ascending aorta establishes the diagnosis. Survival is enhanced if cardiopulmonary bypass is promptly discontinued, aortic cannulation established, and bypass reinstituted with the induction of profound hypothermia. Circulatory arrest may then be employed to repair the false passage. In this series the proposed operation was completed in all six patients.

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Detection of retroperitoneal hemorrhage by transesophageal echocardiography during cardiac surgery

Yamaura

Okamoto

Maekawa

et al. 1999

Can J Anesth/J Can Anesth

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Clinical Reports Detection of retroperitoneal hemorrhage by transesophageal echocardiography during cardiac surgeryPurpose: To present a case of massive retroperitoneal hemorrhage during cardiopulmonary bypass (CPB) which was detected Using transesophageal echocardiography (TEE). Clinical feature: A 50-yr-old man suffering from severe mitral regurgitation (MR) was admitted for mitral valvuloplasty. After the beginning of CPB, the volume in the reservoir was noticed to be gradually decreasing. Although venous cannulation had been properly performed, TEE showed an echo free space around the liver, the spleen and in front of the abdominal aorta showed intraabdominal hemorrhage. After cardiac surgery, emergency laparotomy revealed about 5,000 ml of blood in the retroperitoneal space probably as a result of femoral artery cannulation prior to CPB. Hemostasis was achieved, and the patient made complete cardiac and neurological recovery. Retrospective review of the TEE imaging revealed that the kidneys were surrounded by blood bilaterally confirming the diagnosis of retroperitoneal hemorrhage. Conclusion: Retroperitoneal hemorrhage during CPB is rare, but may be lethal. Transesophageal echocardiography is a useful monitor not only to evaluate cardiac performance, but also to detect unexpected intraabdomihal bleeding during cardiac surgery.

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Retrograde Aortic Dissection Occurring During Cardiopulmonary Bypass

Cited by 13 publications

References 6 publications

Iatrogenic aortic dissection in patients undergoing coronary artery bypass grafting surgery: A systemic review of published literatures

Iatrogenic aortic dissection in patients undergoing coronary artery bypass grafting surgery: A systemic review of published literatures

Retrograde aortic dissection during cardiopulmonary bypass

Detection of retroperitoneal hemorrhage by transesophageal echocardiography during cardiac surgery

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