Ascending aortic dissection as sudden or late complication of cardiac surgery

From January 1987 to December 1991 at Cardiac Surgery Center of Parma were performed 2019 operations under cardiopulmonary bypass (CPB). Ascending aortic dissection occurred as intraoperative complication in 7 (0.34%) patients (group A), and postoperatively in 3 (group B). In this series there were two deaths: one patient of Group A died intraoperatively, the second (group B) suddenly at five days after operation and the diagnosis was possible only on autopsy. The most cases had aortic valvular disease (7/10), with concomitant wall disease predisposing to dissection by surgical manipulations. Surgical techniques depend on the extent of the dissection; furthermore we prefer to repair the lesion under CPB. We believe that successful surgical treatment of the intraoperative dissection is dependent on early recognition.