Clampless myocardial revascularization on a healed iatrogenic aortic dissection

• Published in: Interactive cardiovascular and thoracic surgery Vol. 26; no. 2; pp. 362 - 363
• Main Authors: Blossier, Jean-David, Gabrysz-Forget, Fanny, Tadros, Victor-Xavier, Perrault, Louis P
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.02.2018
• Subjects: Aged; Aneurysm, Dissecting - diagnosis; Aneurysm, Dissecting - etiology; Aneurysm, Dissecting - surgery; Aortic Aneurysm, Thoracic - diagnosis; Aortic Aneurysm, Thoracic - etiology; Aortic Aneurysm, Thoracic - surgery; Cardiac Catheterization - adverse effects; Coronary Artery Disease - diagnosis; Coronary Artery Disease - surgery; Female; Humans; Iatrogenic Disease; Myocardial Revascularization - methods; Tomography, X-Ray Computed; Clampless coronary artery bypass grafting; Coronary angiography complications; Iatrogenic aortic dissection
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivx306

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.