Table 1.
Trends in sites of iatrogenic aortic dissection after cardiac surgery in literature
| Gott et al. [10] (N = 27/11,145) 1982–1988 |
Still et al. [11] (N = 24/14,877) 1980–1990 |
Leontyev et al. [12] (N = 36/55,279) 1995–2010 |
Stanger et al. [5] (N = 103/68,249) 2006–2010 |
|
|---|---|---|---|---|
| 1- Intraoperative | ||||
| (N = 27) | (N = 20) | (N = 31) | (N = 24) | |
| Aortic cannulation | 10 (37 %)a | 10 (50 %)a | 12 (38 %)a | 7 (29.1 %)a |
| Cardioplegia cannula | 5 (18.5 %) | 0 (0 %) | 7 (22.6 %) | 4 (16.7 %) |
| Aortic cross-clamp | 4 (14.8 %) | 8 (40 %) | 4 (12.9 %) | 7 (29.1 %)a |
| Proximal anastomosis | 2 (7.4 %) | 1 (5 %) | 1 (3.2 %) | 5 (20.8 %) |
| Direct aortic injury | 0 (0 %) | 1 (5 %) | 0 (0 %) | 0 (0 %) |
| Unknown | 2 (7.4 %) | 0 (0 %) | 5 (16.1 %) | 1 (4.2 %) |
| 2- Early Postoperative: | ||||
| (N = 4) | (N = 5) | (N = 12) | ||
| Aortic cannulation | 3 (75 %)a | 2 (40 %)a | 0 (0 %) | |
| Cardioplegia cannula | 0 (0 %) | 0 (0 %) | 1 (8.3 %) | |
| Aortic cross-clamp | 1 (25 %) | 0 (0 %) | 1 (8.3 %) | |
| Proximal anastomosis | 0 (0 %) | 1 (20 %) | 8 (66.7 %)a | |
| Aortotomy | 0 (0 %) | 0 (0 %) | 2 (16.7 %) | |
| Unknown | 0 (0 %) | 2 (40 %)a | 0 (0 %) | |
| 3- Late: Postoperative | ||||
| a) Acute | (N = 44) | |||
| Aortic cannulation | 1 (2.2 %) | |||
| Cardioplegia cannula | 0 (0 %) | |||
| Aortic cross-clamp | 2 (4.5 %) | |||
| Proximal anastomosis | 10 (22.7 %) | |||
| Aortotomy | 24 (54.5 %)a | |||
| Unknown | 7 (15.9 %) | |||
| b) Chronic | (N = 23) | |||
| Aortic cannulation | 2 (8.7 %) | |||
| Cardioplegia cannula | 0 (0 %) | |||
| Aortic cross-clamp | 0 (0 %) | |||
| Proximal anastomosis | 9 (39.1 %)a | |||
| Aortotomy | 11 (47.8 %) | |||
| Unknown | 1 (4.3 %) | |||
aRepresents highest incidence in each category within every study