Iatrogenic ascending aortic dissection following cannulation for arterial return and for infusion of cardioplegic solution: Prevention and repair

Two patients are presented in whom dissection of the ascending aorta resulted from cannulation for arterial return and from the infusion of cardioplegic solution. The dissections were recognized promptly. Following dissection in the first patient, the femoral artery was used to reestablish systemic perfusion. The aortic valve and dissected ascending aorta were replaced, and three vessels were grafted. In the second patient, the dissected anterior wall of the ascending aorta was excised and replaced with a low-porosity Dacron patch into which the proximal aortocoronary anastomoses were inserted. Predisposing factors are discussed, along with preventive measures and methods of repair.