[Acute aortic dissection due to cross-clamp injury during coronary artery bypass grafting--a report of successfully repaired case].

A case with successfully repaired acute aortic dissection due to cross-clamp injury during coronary bypass surgery was reported. A 54-year-old man had usual coronary artery bypass surgery by using 3 saphenous vein grafts (4 distal anastomosis). Immediately after the completion of cardiopulmonary bypass, acute aortic dissection, which was caused by aortic cross-clamp, was noted. Cardiopulmonary bypass was resumed and the injured ascending aorta was replaced with prosthetic graft under profound hypothermia and circulatory arrest. An "Island flap" of the ascending aorta (3 x 4 cm in diameter), containing 3 proximal anastomotic positions of vein grafts, was excised from the aortic wall, and was re-implanted into the frontal wall of the aortic prosthesis. The patient well tolerated the operative procedure, and fully recovered from the serious condition after 6 days of IABP support and 11 days of inotropic support. He is doing quite well one year after the surgery. This case is believed to be the first reported one of such reconstructive method for acute aortic dissection during the coronary bypass surgery.