Iatrogenic type A aortic dissection during cardiac procedures: early and late outcome in 48 patients

摘要: OBJECTIVE: Iatrogenic aortic dissection (IAD) is a rare complication of cardiac procedures. We herein describe our management and results this complication. METHODS: A total 55 279 patients underwent open heart surgery at centre from 1995 to 2010, 135 262 catheterization over the same time period. identified 48 cohort who emergency for IAD that occurred either during or shortly after surgery, following catheterization. RESULTS: The incidence was 0.06% (n= 36) surgical procedures 0.01% 12) mean patient age 66 ± 14 years 50% were female. Intraoperative cannulation in 12 patients, insertion cardioplegia cannula 7 manipulation crossclamp 4 other events 8 patients. early postcardiac 5 remaining treated by emergent replacement ascending aorta arch (when involved), as well root repair indicated. Early mortality 41.7: 35.5% intraoperative IAD, 60.0% postoperative 50.0% catheterization-associated (P= 0.5). Histological investigation revealed atherosclerosis 61.2% cystic medial necrosis 22.2%, aortitis 2.8% pathologies 13.8%. Follow-up 100% complete with 5-year survival 40 0.4%. CONCLUSION: but dangerous catheterization, frequently associated pre-existing pathology.