Acute Aortic Dissection During Cardiopulmonary Bypass

A review of over 950 open-heart operations done at St. Mary's Long Beach Hospital from July 1, 1969 through Sept 15, 1973, showed five instances of acute aortic dissection occurring during cardiopulmonary bypass. Three of these patients were successfully resuscitated and were long-term survivors. Routine femoral artery cannulation was carried out in 836 patients. All five dissections occurred in this group. None occurred in the 114 aortic arch cannulations, but three of these patients developed severe bleeding problems at the cannulation site, of which two died. Prompt diagnosis of the acute aortic dissection and immediate treatment were crucial to these patients' survival; vigorous postoperative antihypertensive medical management was likewise an important factor. The occurrence of intraoperative acute aortic dissection is not necessarily fatal if rapidly recognized and properly handled.