Management of aortic dissection that involves the right coronary artery

A report on the follow-up of 11 patients who suffered from aortic dissectio n involving the right coronary artery and who underwent surgical treatment is reported. In two patients, the left coronary ostia was also affected. In seven patients, the dissection was acute and in four. chronic. The ascendi ng aorta was substituted by a Dacron graft in all patients, and right coron ary artery saphenous vein bypass or Gore-Tex graft to the coronary ostia or right coronary artery was performed in nine, and reimplantation of both di ssected coronary in two. There were three early postoperative deaths (27.3% ) caused by low-output syndrome and myocardial infarction, There were two l ate deaths. The six surviving patients were followed-up from 78 to 96 month s (mean 83 months). This experience suggests that although carrying a high risk, the involvement of the coronary ostia in aortic dissection can be suc cessfully managed if made before irreversible complications arise. (C) 1999 The International Society for Cardiovascular Surgery. Published by Elsevie r Science Ltd. All rights reserved.