ABSTRACT
The Enlarged Aorta (Fig. 1) With constant aging of the current surgical population, degenerative atherosclerotic changes
of the ascending aorta are common findings. In these circumstances, side-clamping of the physiological, pressurized aorta is troublesome and can predispose to aortic dissection.7 Early in our institutional experience, we were confronted with patients who sustained ascending aortic dissection (AAD) due to side-bite clamping, which raised concerns about the incidence of this complication. With time and experience however, its incidence has gone down. Currendy, in our practice, over 900 systematic OPCABs, acute AADs in the first week of the procedure have occurred on 3 occasions (0.3%). In the first case, the dissection was recognized at surgery, and the patient underwent successful ascending aortic replacement. In the two other patients, the dissection occurred 1 week after the initial procedure. Both patients died on the table during a surgical attempt to repair the ascending aorta.
