Two Aortic Ruptures in Two Months-Role of Cross-Clamp-Associated Late Injury

Abstract

Background: Aortic cross-clamping may lead to iatrogenic tissue damage resulting in immediate or later aortic dissection or rupture.

Methods: We report on a patient with an acute type B aortic dissection with mega-aortic syndrome whose aorta ruptured twice within 2 months.

Results: The second aortic rupture occurred at the level of prior cross clamping. The pressure along the clamp jaws is distributed unequally. According to the law of the lever, the aortic area near the hinge is under more stress than the aortic area distal to the hinge. Unequal pressure distribution may injure the aorta.

Conclusions: There is a need to evaluate pressure distribution along the various currently available aortic clamp jaws and to develop the perfect aortic clamp providing equal pressure distribution designed especially to clamp large aortas or those of patients with connective tissue disorders.