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Eur J Cardiothorac Surg 2000;18:617-618
© 2000 Elsevier Science NL

Case report

Atherosclerotic disruption of the aortic arch during coronary artery bypass operation

Clinic for Cardiovascular Surgery and Diagnostic Radiology, University Hospital of Berne (Inselspital), CH-3010 Berne, Switzerland

Received 16 May 2000; received in revised form 27 July 2000; accepted 15 August 2000.

Corresponding author. Tel.: +41-316-322-375; fax: +41-313-820-279
e-mail: thierry.carrel{at}insel.ch

A 70-year-old-man presented with a symptomatic three vessel coronary artery disease and was scheduled for myocardial revascularization. During extracorporeal circulation an intrathoracal bleeding occurred and aortic rupture was suspected. An iatrogenic plaque rupture in the concavity of the aortic arch was found due to cannulation attempts. The aortic arch was grafted in the so-called elephant trunk technique. Thereafter bypass grafts were anastomosed to the stenosed coronary arteries. The patient was discharged from hospital after 2 weeks in good condition.

Key Words: Coronary surgery • Iatrogenic cannulation injuries • Atherosclerotic aortic arch ulcer • Aortic arch replacement • Elephant trunk

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