Aortic posterior wall perforation with automatic aortic cutter during routine off-pump coronary bypass grafting.
Aortic complications are very rare during off-pump coronary artery bypass grafting (OPCAB). When they occur, the mortality is high. We report a case of perforation of the posterior aortic wall after punching out the hole in the ascending aorta with an automatic aortic cutter to avoid clamping for the proximal anastomosis during a routine OPCAB procedure. The consequence was a massive hemorrhage, emergency conversion to cardiopulmonary bypass and replacement of the aortic valve and of the ascending aorta.
Syburra
Thomas
T
Division of Cardiac Surgery, City Hospital Triemli, Zurich, Switzerland. thomas.syburra@triemli.stzh.ch
Reuthebuch
Oliver
O
Graves
Kirk
K
Genoni
Michele
M
D000368:Aged; D001011:Aorta / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D001019:Aortic Rupture / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects* / Q000295:instrumentation; D023921:Coronary Stenosis / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics; D006470:Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome