Aortic perforation caused by friction of a chest tube after coronary artery bypass surgery.

Aortic perforation caused by the friction of a chest tube is a rare but life-threatening complication of coronary artery bypass grafting (CABG). We report a case involving CABG for triple-vessel disease and unstable angina. Reexploration was necessary 24 hours after the operation because of the sudden onset of pronounced bleeding. Perforation of the ascending aorta caused by friction of the chest tube was found. Bleeding was controlled by means of a purse string suture with 4-0 Prolene. Use of pericardium membrane between the heart and the chest tube and the choice of smaller and more flexible Silastic chest tubes in high-risk patients can probably reduce the incidence of this complication.