Key result
In a systematic review of 27 patients who developed iatrogenic aortic dissection following CABG surgery, most experienced type A dissection and overall mortality was 33.3% (9 deaths).
Why the study?
Iatrogenic aortic dissection is a rare, highly lethal, and often asymptomatic complication following CABG surgery, requiring optimized preoperative evaluation and improved early recognition and management strategies.
Systematic Review (n=27)
Iatrogenic aortic dissection during CABG is a rare but highly lethal complication, predominantly presenting as type A dissection, with surgical management restoring health in the majority of treated cases.
Alerts clinicians to high lethality of iatrogenic aortic dissection in CABG; leaves open optimal prevention strategies given sparse data.
BACKGROUND: Iatrogenic aortic dissection (IAD) is a rare but highly lethal complication that may occur following coronary artery bypass grafting (CABG) surgery. Aortic dissection (AD) is often asymptomatic, making early detection difficult. We aimed to optimize preoperative evaluation strategies of CABG surgery for minimizing the incidence of IAD and assess early recognition and management of IAD for improving outcomes. METHODS: Electronic databases were searched to identify all case reports of patients undergoing CABG surgery who developed IAD. Clinical characteristics, operative information, perioperative management, and patient outcomes were compiled and analyzed. RESULTS: Nineteen case reports involving 27 patients aged 50 to 81 were included. Patients were from Europe (n = 23) and Asia (n = 4), mostly men (n = 25). The aorta was described as normal, abnormal, and unmentioned (n = 8, 5, and 14, respectively). Sixteen patients had a bypass with more than 3 grafts. Most patients (n = 25) experienced type A dissection. There were intraoperative (n = 12) and postoperative (n = 15) cases. Surgery (n = 19) was the most common treatment, with 9 patients selecting deep hypothermic circulatory arrest. Eighteen patients were restored to health, while 9 patients died (3 died before treatment). CONCLUSIONS: Our study focused on patients with IAD and developed a recommended management protocol for patients undergoing CABG surgery.
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Yuan et al. (2024) conducted a systematic review in Iatrogenic aortic dissection following coronary artery bypass grafting surgery (n=27). Coronary artery bypass grafting (CABG) surgery was evaluated on Mortality. In a systematic review of 27 patients who developed iatrogenic aortic dissection following CABG surgery, most experienced type A dissection and overall mortality was 33.3% (9 deaths).
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