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Aortic posterior wall perforation with automatic aortic cutter during routine off-pump coronary bypass grafting

Division of Cardiac Surgery, City Hospital Triemli, Zurich, Switzerland

*Corresponding author. Clinic for Cardiac Surgery, Triemli Hospital, Birmensdorferstrasse 497, CH-8063 Zürich, Switzerland. Tel.: +41 44 466 11 79; fax: +41 44 466 27 45.

E-mail address: thomas.syburra{at}triemli.stzh.ch (T. Syburra).

Aortic complications are very rare during off-pump coronary artery bypass grafting (OPCAB). When they occur, the mortality is high. We report a case of perforation of the posterior aortic wall after punching out the hole in the ascending aorta with an automatic aortic cutter to avoid clamping for the proximal anastomosis during a routine OPCAB procedure. The consequence was a massive hemorrhage, emergency conversion to cardiopulmonary bypass and replacement of the aortic valve and of the ascending aorta.

Key Words: Aortic puncher; Off-pump bypass grafting; Aortic complications