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Reza Tavakoli
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Ann Thorac Surg 2005;80:316-318
© 2005 The Society of Thoracic Surgeons

Case report

Aortic Dissection With Potential Origin From a Mechanical Bypass Anastomosis

Martin Zinkernagel, MD, Markus J. Wilhelm, MD, Reza Tavakoli, MD, Marko I. Turina, MD, Michele Genoni, MD*

Department of Cardiovascular Surgery, City Hospital Triemli, Zurich, Switzerland

Accepted for publication December 10, 2003.

* Address reprint requests to Dr Genoni, Department of Cardiovascular Surgery, City Hospital Triemli, Birmensdorfer Str 497, 8063 Zurich, Switzerland (Email: michele.genoni{at}triemli.stzh.ch).

Ascending aortic dissection is a known complication of cardiac surgery. Off-pump coronary artery bypass surgery seems to be associated with a higher risk for this event as compared with on-pump bypass surgery. This increased risk may result from aortic side-clamping under pulsatile flow as opposed to continuous flow in conventional bypass surgery. Mechanical devices allowing performance of proximal bypass anastomoses without aortic side-clamping are supposed to reduce the risk for aortic dissection. We report a case in which ascending aortic dissection occurred 8 days after off-pump bypass surgery, most likely arising from a mechanically performed proximal bypass anastomosis.






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