• Xi Yuan, Yanting Sun, Huaqiu Chen, Qiqing Lan, Wen Wu, Yuntai Yao, and Evidence in Cardiovascular Anesthesia (EICA) Group.
• Department of Anesthesiology, Xichang People's Hospital, Xichang, China.
• Medicine (Baltimore). 2024 Mar 22; 103 (12): e37472e37472.

BackgroundIatrogenic 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.MethodsElectronic 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.ResultsNineteen 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).ConclusionsOur study focused on patients with IAD and developed a recommended management protocol for patients undergoing CABG surgery.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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