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Aortic Dissection Rare but Lethal Complication of Cardiac Surgery: Presented at STS By Charlene Laino FORT LAUDERDALE, Fla -- January 26, 2010 -- Aortic dissection is a rare but lethal complication of cardiac surgery, and femoral cannulation appears to increase the frequency of this complication, researchers reported here at the Society of Thoracic Surgeons (STS) 46th Annual Meeting. Avoiding femoral artery cannulation might help lower the number of aortic dissections, said Matthew L. Williams, MD, Assistant Professor of Surgery, University of Louisville, Kentucky. Dr. Williams presented the Richard E. Clark Award Presentation here on January 25. The researchers analysed the STS National Database, which has information on 2,219,991 cardiac surgeries, including coronary artery bypass grafting (CABG), aortic valve surgery, or mitral valve surgery. Of the total, 1,294 patients suffered aortic dissection as a complication of their surgery. This corresponded to an incidence of 0.06% -- “about 6 in every 10,000 cases,” said Dr. Williams. When looked at by procedure, the rates of aortic dissection were 0.06% for isolated mitral surgery, 0.06% for CABG, and 0.09% for isolated aortic valve surgery. “While aortic dissection is a low frequency, it is a catastrophic event. [A total of] 615 of the 1,294 [48%] patients suffered operative mortality,” he said. “Aortic dissection is responsible for 1% of fatalities in perioperative cardiac surgery.” Additionally, 9.2% of survivors had strokes and 13.5% of survivors developed renal failure, Dr. Williams reported. In a logistic regression model based on 2004-2007 STS data, major risk factors for aortic dissection included femoral cannulation, preoperative steroids, and Asian race. Based on the data, Dr. Williams suggested that surgeons avoid femoral access whenever possible and choose either central aortic cannulation or axial cannulation. [Presentation title: Aortic Dissection as a Complication of Cardiac Surgery: A Report From the STS National Database. Abstract 4] E-mail this page to a friend or colleague! To print, use this version