Coronary artery bypass grafting after iatrogenic coronary artery dissection: A single center eight years' experience

Abstract

Background: Iatrogenic coronary artery dissection during diagnostic or therapeutic catheterization is a rare and mortal complication that may result in a newly developed myocardial infarction. In this study, we aimed to share the results of CABG treatment of patients with iatrogenic coronary artery dissection after coronary angiography (CAG) in our clinic. Method(s): All patients who underwent CAG or percutaneous coronary intervention (PCI) in our hospital between January 2014 and December 2021 were analyzed retrospectively and patients who underwent CABG after iatrogenic coronary artery dissection were included in the study. The dissection classification was achived according to the National Heart, Lung and Blood Institute (NHLBI) classification. Result(s): During the eight years, CAG was applied to 20,398 patients and PCI to 9583 patients. Needed to treat CABG in iatrogenic coronary artery dissection developed in 17 of the patients (0.06%). LMCA was dissected in 6 (35.3%) patients and LAD in 6 (35.3%), CX in 2 (11.8%) and RCA dissection in 3 (17.6%). 3 patients (17.6%) had an intubation time longer than 48 hours. One of them has recently had a COVID infection. Another was suffering from pulmonary edema. The other patient died on the 4th postoperative day due to low cardiac output. The length of stay in the intensive care unit was 2 (min: 1 - max: 13) days. The hospital stay was 6 (min: 4 - max: 20) days. Conclusion(s): The development of a critical clinical condition prior to surgery is strongly associated with a higher probability of early and late postoperative death. For this reason, it is clear that the treatments applied at every stage of the pre-, per-, and postoperative period are the most important determinants of the results.Copyright © 2023, CKS.