Vessels’ injury in cardiopulmonary bypass

Vessels’ injuries are potential complications at the time of cardiac surgery, performed either with conventional invasive approaches (e.g., median sternotomy) or minimally invasive access to the body. Most common lesions are vessel’s dissection, abnormal and focal dilation—pseudoaneurysms—or stenosis, which often require surgical reinterventions to be repaired. Complications after cardiopulmonary bypass/extracorporeal membrane oxygenation cannulation mostly happen on smaller and peripheral vessels, but also anatomical consequences of intraoperative cannula insertion can occur on the ascending aorta, requiring major surgical procedure to be solved (e.g., replacement of the ascending aorta). Lymphoceles are also described in this chapter as frequent complications related to peripheral vessels isolation and cannulation, although not direct cannulation is doable or indicated on lymphatic vessels. The severity of vessels’ injuries varies from mild forms that can be only monitored and medically treated, to life-threatening conditions, which may require surgical intervention, also major, for an effective resolution.