Subintimal retrograde perfusion during repair of aortic dissection: a potential cause of disaster.

During operations done for dissection of the proximal aorta, a selective retrograde perfusion of the false lumen may occur in spite of correct placement of the cannula in the femoral artery. This happens through a re-entry orifice at the level of the descending thoracic aorta and may seriously compromise the cerebral and coronary circulation. This paper describes this observation in a patient successfully treated and discusses the diagnosis and treatment of this potentially catastrophic complication.