Early diagnosis and rapid surgical repair of iatrogenic perioperative ascending aortic dissection yields good survival outcomes, with the timing of diagnosis dictating the extent of repair required.
Early diagnosis may allow less extensive repair in iatrogenic aortic dissection; case reports leave open need for larger studies before practice change.
Iatrogenic aortic injury occurring during either coronary bypass grafting or valve replacement is a well-recognized complication of cardiac surgery. We retrospectively reviewed our experience and found 11 cases occurring in a case load of 8,945 hearts (incidence of 0.12%). All 11 cases were repaired, with 10 patients surviving. The type of repair used usually was determined by when the diagnosis was made. When an intraoperative diagnosis was made, a local repair was done in four of six cases. If a postoperative diagnosis was made, then all five patients needed the ascending aorta replaced. With early diagnosis and rapid repair, good surgical results can be achieved.
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Blakeman et al. (1988) studied this question.
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